Cardiac markers used in the detection of myocardial injury.
OBJECTIVE
Activities of total creatine kinase and its isoform creatine kinase are usually significantly elevated in patients with myocardial or skeletal muscle injury as well as in those with renal failure. The purpose of this study was to compare findings for creatine kinase mass, cardiac troponin T and cardiac troponin I with those of creatine kinase and creatine kinase MB activity.


METHODS
Blood samples from 118 patients were studied. Fifty eight patients had significantly elevated creatine kinase activity (39 with and 19 without clinically proven myocardial injury or infarction) and 60 were normal controls. The sensitivity, specificity, positive and negative predictive values were calculated for all markers.


RESULTS
Cardiac troponins had 100% sensitivity and negative predictive value, for myocardial injury, as compared with 92% and 96% for creatine kinase activity and 96% and 97% for creatine kinase-mass. Cardiac TnI had the highest specificity and positive predictive value (99% and 98%) as compared with cardiac troponin T (96% and 93%), creatine kinase-mass (92% and 86%) and creatine kinase activity (89% and 80%).


CONCLUSIONS
Cardiac troponins, especially cardiac troponin T, have very high sensitivity, specificity and predictive value for myocardial injury.
Sobki
S H
SH
Department of Pathology, Riyadh Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia.
Saadeddin
S M
SM
Habbab
M A
MA
D015415:Biomarkers; D003402:Creatine Kinase / Q000097:blood*; D052279:Creatine Kinase, MB Form; D003937:Diagnosis, Differential; D006335:Heart Injuries / Q000175:diagnosis* / Q000201:enzymology; D006801:Humans; D007527:Isoenzymes / Q000097:blood*; D018482:Muscle, Skeletal / Q000293:injuries; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000201:enzymology; D011237:Predictive Value of Tests; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood*
D015415:Biomarkers; D007527:Isoenzymes; D019210:Troponin I; D020107:Troponin T; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form