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Q J Med 1999; 92: 711-718
© 1999 Association of Physicians

Troponin-I, myoglobin, and mass concentration of creatine kinase-MB in acute myocardial infarction

A. Chiu, W.-K. Chan, S.-H. Cheng1, C.-K. Leung1 and C.-H. Choi1

From the Cardiology Division, Department of Medicine and Geriatrics, and 1 Chemical Pathology Division, Department of Pathology, United Christian Hospital, Hong Kong

Received 4 August 1999 and in revised form 11 September 1999

Dr W.-K. Chan, Cardiology Division, Department of Medicine and Geriatrics, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Kowloon, Hong Kong

Myoglobin, creatine kinase-MB (CKMB) mass concentration and troponin-I are newer biochemical markers for the diagnosis of acute myocardial infarction (AMI). We conducted a prospective study to formulate a model for the collective interpretation of these three markers in the diagnosis of AMI. Eighty-seven patients with AMI had serial serum samples taken to establish the time-frame sensitivity of individual markers. None of the markers had a good sensitivity within the first 4 h of infarction. Myoglobin and CKMB (mass) had sensitivities of 92.3% and 96.2%, respectively, at 4–8 h post infarct. CKMB (mass) and troponin-I had sensitivities >92% at 8–24 h. Troponin-I maintained sensitivity >93% until 72 h. A guideline was formulated based on the results. Our data suggest that troponin-I, myoglobin and CKMB (mass) yield satisfactory diagnostic sensitivity when used with reference to specific time frames. The combined use of these markers can provide valuable information for clinicians in managing AMI patients.


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