title: The clinical utility of CK-MB measurement in patients suspected of acute coronary syndrome.
abstract: BACKGROUND
  This study aims to assess the clinical utility of CK-MB measurement in patients suspected of acute coronary syndrome (ACS).
  
  
  METHODS
  All CK-MB and troponin T measurements performed <1h apart during the study period were obtained and analyzed for concordance. A total of 1214 cases with discordant biomarkers results were found. Retrospective review of electronic health records (EHRs) was performed to assess the clinical impact, if any, of the discordant biomarkers results.
  
  
  RESULTS
  In 401 cases, CK-MB concentrations were increased whereas troponin T concentrations were negative at <0.01 ng/ml. In this group, clinical interpretations included, rhabdomyolysis, demand ischemia, and drug intoxication. No additional investigations for ACS were conducted in this group. Among the remaining 813 cases, troponin T concentrations were increased in the presence of a normal CK-MB result. In this group, the discordant normal CK-MB lowered suspicion for ACS in only 22 cases (2.7%). Most common interpretations for isolated positive troponin were demand ischemia and impaired renal function. In most cases, discordant CK-MB results were not considered a significant finding.
  
  
  CONCLUSIONS
  In the setting of suspected ACS, CK-MB has limited clinical impact when contemporary troponin assay results are available.
authors.affiliation: Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Department of Pathology, Parkland Memorial Hospital, Dallas, TX 75390, USA.
authors.forename: Jaehyup
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Department of Pathology, Parkland Memorial Hospital, Dallas, TX 75390, USA. Electronic address: Ibrahim.Hashim@utsouthwestern.edu.
authors.forename: Ibrahim A
authors.initials: IA
authors.lastname: Hashim
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000378:metabolism*; D052279:Creatine Kinase, MB Form / Q000378:metabolism*; D005260:Female; D006801:Humans; D007118:Immunoassay; D008297:Male; D012189:Retrospective Studies; D020107:Troponin T / Q000378:metabolism
chemical_list: D020107:Troponin T; D052279:Creatine Kinase, MB Form
keywords: Acute coronary syndrome; Creatine kinase; Troponin