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

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 collec tive interpretation of these three markers in the diagnosis of AMI. Eighty- seven patients with AMI had serial serum samples taken to establish the tim e-frame sensitivity of individual markers. None of the markers had a good s ensitivity within the first 4 h of infarction. Myoglobin and CKMB (mass) ha d sensitivities of 92.3% and 96.2%, respectively, at 4-8 h post infarct. CK MB (mass) and troponin-I had sensitivities >92% at 8-24 h. Troponin-I maint ained 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 ti me frames. The combined use of these markers can provide valuable informati on for clinicians in managing AMI patients.