BACKGROUND Millions of patients present annually with chest pain, but only 10% to 15% have myocardial infarction. Lack of diagnostic sensitivity and specificity of clinical and conventional markers prevents or delays treatment and leads to unnecessary costly admissions. Comparative data are lacking on the new markers, yet using all of them is inappropriate and expensive. METHODS AND RESULTS T...

Dr. Januzzi and colleagues in a recent study (1) published in the Journal suggest replacement of creatine kinase-MB fraction (CKMB) with serum troponin testing for postoperative evaluation of the cardiac surgical patient. An important point to remember is the release pattern of these markers. Although the rise (CK-MB 4 to 8 h; CK-MB isoform 2 to 6 h; cardiac troponin I [cTnI] 4 to 6 h; cardiac ...

Background—Millions of patients present annually with chest pain, but only 10% to 15% have myocardial infarction. Lack of diagnostic sensitivity and specificity of clinical and conventional markers prevents or delays treatment and leads to unnecessary costly admissions. Comparative data are lacking on the new markers, yet using all of them is inappropriate and expensive. Methods and Results—The...

ultiple etiological factors have to be considered when faced with isolated elevation of Creatine Kinase-MB (CK-MB), an isoenzyme of Creatine Kinase (CK) without any change in total CK or increase in Troponin. These factors must be kept in mind before diagnosing a patient with acute coronary syndrome (ACS) and subjecting them to further investigation and therapy which could involve anticoagulati...

Objective—To test whether fatty acid binding protein (FABP) is a useful plasma marker for the early detection of exercise induced skeletal muscle injury in healthy subjects. Methods—Plasma concentrations of FABP and myoglobin (Mb) were measured in six healthy physical education teacher trainees after 20 minutes of downhill running (16% incline; mean lactate 4 mmol/l; 70% VO2MAX). Creatine kinas...

Among the conditions in which creatine kinase (CK)-MB activity is elevated in the absence of myocardial injury or infarction, macroenzyme (macro) CK merits special attention from clinicians. We present 2 cases, 1 with macro CK type 1 and the other with macro CK type 2, to stress the common clinical situations and diagnostic dilemma that clinicians encounter when evaluating patients with macro C...

Dr. Januzzi and colleagues in a recent study (1) published in the Journal suggest replacement of creatine kinase-MB fraction (CKMB) with serum troponin testing for postoperative evaluation of the cardiac surgical patient. An important point to remember is the release pattern of these markers. Although the rise (CK-MB 4 to 8 h; CK-MB isoform 2 to 6 h; cardiac troponin I [cTnI] 4 to 6 h; cardiac ...