Medical tests that are often referred to as cardiac markers include:
cardiac troponin
(the most sensitive and specific test for myocardial damage)
creatine kinase
(CK, also known as phosphocreatine kinase or creatine phosphokinase)
Aspartate transaminase
(AST, also called Glutamic Oxaloacetic Transaminase (GOT/SGOT) or aspartate aminotransferase (ASAT))
lactate dehydrogenase (LDH)
Myoglobin
(Mb) has low specificify for myocardial infarction and is used less than the other markers.
Kinetics of cardiac markers in myocardial infarction with or without reperfusion treatment.
Cardiac markers are substances released from heart muscle when it is damaged as a result of myocardial infarction.
Depending on the marker, it can take between 2 to 24 hours for the level to increase in the blood. Additionally, determining the levels of cardiac markers in the laboratory - like many other lab measurements - takes substantial time.
Cardiac markers are therefore not useful in diagnosing a myocardial infarction in the acute phase. The clinical presentation and results from an ECG are more appropriate in the acute situation.
Myocardial markers in myocardial infarction
Ischemia-Modified Albumin (IMA) can be detected via the albumin cobalt binding (ACB) test, a limited available FDA approved assay. Myocardial ischemia alters the N-terminus of albumin reducing the ability of cobalt to bind to albumin.
IMA measures ischemia in the blood vessels and thus returns results in minutes rather than traditional markers of necrosis that take hours.
ACB has low specificity therefore generating high number of false positives and must be used in conjunction with typical acute approaches such as ECG and physical exam. Additional studies are required.
• eAbnormal clinical and laboratory findings
Blood test red blood cells
(Elevated ESR, Anisocytosis, Poikilocytosis, Reticulocytosis)
- blood sugar (Abnormal glucose tolerance test, Hyperglycemia) -
enzymes (Elevated transaminases, Cardiac marker) -
elevated alpha-fetoprotein - mineral (Iron overload disorder) - pathogens (Bacteremia,
Viremia)
Urine test
Proteinuria (Albuminuria, Microalbuminuria) - Glycosuria - Chyluria - Myoglobinuria - Bilirubinuria - Hemoglobinuria - Ketonuria - Crystalluria
Other Abnormal basal metabolic rate
troponin .....> elevated in blood within 3-4 hr's and remain elevated for 10-14 days
CK ......> elevated after 4-6 hr's return to normal 2-3 days
CK-MB .......> most sensitive after 4 hr's return to normal 2.5 days
LDH ......> sensitive after 12 hr's return to normal within 10 days
AST ........> sensitive after 6 hr's return to normal within 4 days
cardiac troponin
(the most sensitive and specific test for myocardial damage)
creatine kinase
(CK, also known as phosphocreatine kinase or creatine phosphokinase)
Aspartate transaminase
(AST, also called Glutamic Oxaloacetic Transaminase (GOT/SGOT) or aspartate aminotransferase (ASAT))
lactate dehydrogenase (LDH)
Myoglobin
(Mb) has low specificify for myocardial infarction and is used less than the other markers.
Kinetics of cardiac markers in myocardial infarction with or without reperfusion treatment.
Cardiac markers are substances released from heart muscle when it is damaged as a result of myocardial infarction.
Depending on the marker, it can take between 2 to 24 hours for the level to increase in the blood. Additionally, determining the levels of cardiac markers in the laboratory - like many other lab measurements - takes substantial time.
Cardiac markers are therefore not useful in diagnosing a myocardial infarction in the acute phase. The clinical presentation and results from an ECG are more appropriate in the acute situation.
Myocardial markers in myocardial infarction
Ischemia-Modified Albumin (IMA) can be detected via the albumin cobalt binding (ACB) test, a limited available FDA approved assay. Myocardial ischemia alters the N-terminus of albumin reducing the ability of cobalt to bind to albumin.
IMA measures ischemia in the blood vessels and thus returns results in minutes rather than traditional markers of necrosis that take hours.
ACB has low specificity therefore generating high number of false positives and must be used in conjunction with typical acute approaches such as ECG and physical exam. Additional studies are required.
• eAbnormal clinical and laboratory findings
Blood test red blood cells
(Elevated ESR, Anisocytosis, Poikilocytosis, Reticulocytosis)
- blood sugar (Abnormal glucose tolerance test, Hyperglycemia) -
enzymes (Elevated transaminases, Cardiac marker) -
elevated alpha-fetoprotein - mineral (Iron overload disorder) - pathogens (Bacteremia,
Viremia)
Urine test
Proteinuria (Albuminuria, Microalbuminuria) - Glycosuria - Chyluria - Myoglobinuria - Bilirubinuria - Hemoglobinuria - Ketonuria - Crystalluria
Other Abnormal basal metabolic rate
troponin .....> elevated in blood within 3-4 hr's and remain elevated for 10-14 days
CK ......> elevated after 4-6 hr's return to normal 2-3 days
CK-MB .......> most sensitive after 4 hr's return to normal 2.5 days
LDH ......> sensitive after 12 hr's return to normal within 10 days
AST ........> sensitive after 6 hr's return to normal within 4 days
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