Document Detail

Discordant results of CK-MB and troponin I measurements: a review of 14 cases.
MedLine Citation:
PMID:  10807160     Owner:  NLM     Status:  MEDLINE    
In the course of a clinical comparison involving 204 parallel total creatine kinase (CK), creatine kinase-MB isoenzyme (CK-MB), and cardiac troponin I (cTnI) measurements, 12 patients were identified in whom cTnI was elevated while total CK was normal, as well as 2 patients in whom CK-MB was elevated while cTnI was normal. CK-MB relative index was elevated in 6 of the twelve cTnI-positive patients with normal total CK; only 2 of these patients had a discharge diagnosis of acute myocardial infarction (AMI). All of the 12 patients in this group had medical conditions that are associated with greater risk for acute cardiac events. Both patients with normal cTnI but elevated total CK and CK-MB index had chronic renal insufficiency; one of these patients had a positive stress test and a diagnosis of AMI. The other cTnI-negative patient died 2 days after admission, and autopsy revealed evidence of ischemic changes, but not acute infarction. Significant differences were apparent between traditional CK-MB results and cTnI measurements. Using total CK elevation as a prerequisite for subsequent CK-MB measurement may limit the clinical sensitivity of this enzyme marker for detecting subacute ischemic damage to the myocardium. Elevated total CK and CK-MB isoenzyme without corresponding elevations in cTnI, on the other hand, may reflect changes in enzyme elimination kinetics due to renal failure, or cross-reactivity of the cTnI assay with non-cardiac antigens.
A E Bennett; R L Bertholf
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of clinical and laboratory science     Volume:  30     ISSN:  0091-7370     ISO Abbreviation:  Ann. Clin. Lab. Sci.     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-08-02     Completed Date:  2000-08-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0410247     Medline TA:  Ann Clin Lab Sci     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  167-73     Citation Subset:  IM    
Department of Pathology, University of Florida Health Science Center, Jacksonville, USA.
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MeSH Terms
Biological Markers
Chemistry, Clinical / standards*
Chest Pain / diagnosis,  enzymology
Creatine Kinase / analysis*
Emergency Medical Services
Middle Aged
Myocardial Infarction / diagnosis*,  enzymology
Retrospective Studies
Sensitivity and Specificity
Troponin I / analysis*
Reg. No./Substance:
0/Biological Markers; 0/Isoenzymes; 0/Troponin I; EC Kinase

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