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Serum Cardiac MarkerAka: Cardiac Marker
- Indications
- Myocardial Infarction Evaluation
- Best protocol for identifying AMI when EKG normal
- Protocol
- Obtain Troponin at 0 hours, 8 hours and 16 hours
- Primary cardiac marker: Specific for cardiac event
- Not useful for monitoring event extension
- Levels stay elevated for 14 days
- Obtain CK-MB at 0 hours, 8 hours, and 16 hours
- Primary purpose: Follow cardiac event extension
- Decreases more rapidly than Troponin after event
- Obtain Troponin at 0 hours, 8 hours and 16 hours
- Test Sensitivity of combined protocol
- Test Sensitivity: >98% at 8 hours
- Test Specificity: 80 to 95% at 8 hours
- References
- Protocol
- Troponin
- Rises: 3-6 hours
- Peaks: 20 hours
- Duration: 14 days
- Subunits
- Troponin T
- Troponin I (>1.0 suggests Acute MI)
- Creatine Phosphokinase (CPK)
- Myoglobin
- Advantage: First cardiac marker to increase
- Disadvantage: Poor Specificity (only helps if negative)
- Rises: 1-2 hours
- Peaks: 4-6 hours
- Duration: 1-2 days
- Glutamic oxaloacetic transaminase (AST, SGOT)
- Peaks: 24-36 hours
- Duration: 5 days
- Lactic Dehydrogenase (LDH)
- Peaks: 24-48 hours
- Duration: 14 days
- White Blood Cell Count
- Predicts adverse events in Unstable Angina
- Morbidity and mortality increase with increased WBCs
- References
Cardiac markers (C1271630) | |
|---|---|
| Concepts | Laboratory Procedure (T059) |
| English | Cardiac markers |
| Spanish | determinacion de marcadores cardiacos |
| Parent Concepts | Clinical Enzyme Tests (procedure) (C0014440), Duplicate concept (C1274013) |
| Sources | SCTSPA, SNOMEDCT Derived from the NIH UMLS (Unified Medical Language System) |
