title: Myoglobin, creatine kinase MB isoforms and creatine kinase MB mass in early diagnosis of myocardial infarction in patients with acute chest pain.
abstract: OBJECTIVE
  Measurements of myoglobin and creatine kinase (CK)-MB isoforms have been suggested to be sensitive tests for the early diagnosis of myocardial infarction (MI). We have investigated the utility of myoglobin, creatine kinase (CK)-MB isoforms and creatine kinase MB mass (CK-MBm) in early diagnosis of MI using cardiac troponin T (cTnT) positivity as a reference.
  
  
  METHODS
  The study population comprised 440 patients who had had chest pain for less than 12 h. Patients were divided into cTnT negative (cTnT-) or cTnT positive (cTnT+) patients (concentration of cTnT >0.1 microg/L at two different time points during 72 h).
  
  
  RESULTS
  At the time of admission to the emergency department receiver operating characteristics (ROC) curves of CK-MB isoforms and CK-MBm were not better than that of myoglobin. Six hours after admission CK-MB isoforms and CK-MBm provided statistically significantly larger areas under the curve (AUC) than myoglobin (p < 0.01). When ROC curves were related to the onset of chest pain (< 3 h, 3-6 h, and > 6 h) there were no significant differences between the cardiac markers studied.
  
  
  CONCLUSIONS
  According to the present findings, CK-MB isoforms or myoglobin offer no advantage over CK-MBm as early markers of myocardial infarction.
authors.affiliation: Department of Clinical Chemistry, Kuopio University Hospital, Kuopio, Finland. karri.penttila@kuh.fi
authors.forename: Karri
authors.initials: K
authors.lastname: Penttilä
authors.forename: Heli
authors.initials: H
authors.lastname: Koukkunen
authors.forename: Matti
authors.initials: M
authors.lastname: Halinen
authors.forename: Tapio
authors.initials: T
authors.lastname: Rantanen
authors.forename: Kalevi
authors.initials: K
authors.lastname: Pyörälä
authors.forename: Kari
authors.initials: K
authors.lastname: Punnonen
authors.forename: Ilkka
authors.initials: I
authors.lastname: Penttilä
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood*; D052279:Creatine Kinase, MB Form; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000097:blood*; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis*; D009211:Myoglobin / Q000097:blood*; D020033:Protein Isoforms; D012372:ROC Curve; D020107:Troponin T / Q000097:blood
chemical_list: D015415:Biomarkers; D007527:Isoenzymes; D009211:Myoglobin; D020033:Protein Isoforms; D020107:Troponin T; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form