ACUTE CORONARY SYNDROME-INVESTIGATION

SUMMARY

1. Troponin I and troponin T (TnI and TnT), are now the gold standard for the detection of MI.

2. Troponins become elevated at 4 hrs following an MI, peak at 44 hrs & remain elevated for 10-14 days.

3. Troponins are also elevated in CKD, pericarditis, HF, sepsis, PE, and cardiac trauma, RV strain.

4. CKMB is specific to myocardium, detectable at 3-12 hrs following Ml, peaks at 24 hrs. Returns to normal after 48-72 hrs, earlier than troponins.

5. Myoglobin is a sensitive, non-specific, rises rapidly, so a negative result can rule out an infarction (high negative predictive value). Returns to normal within 24 hrs.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].