Key result
CK-MB subforms were the most sensitive early marker for myocardial infarction at 6 hours after symptom onset, exhibiting 91% sensitivity and 89% specificity.
Why the study?
Conventional markers lack diagnostic sensitivity and specificity for myocardial infarction, and comparative data on new biomarkers are lacking.
Does the measurement of early and late cardiac biomarkers (CK-MB subforms, myoglobin, troponins) accurately diagnose myocardial infarction in patients presenting with suspected ACS compared to CK-MB mass?
Observational (n=155)
Double-blind
Yes
Does the measurement of early and late cardiac biomarkers (CK-MB subforms, myoglobin, troponins) accurately diagnose myocardial infarction in patients presenting with suspected ACS compared to CK-MB mass?
CK-MB subforms and myoglobin are highly sensitive early markers for myocardial infarction within 6 hours of symptom onset, whereas troponins and total CK-MB activity are more reliable late markers.
May support early CK-MB subform use in suspected ACS; hypothesis-generating and requires prospective validation before practice change.
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. The older markers like aspartate amino-transferase, creatine kinase, lactate dehydrogenase etc. lost their utility due to lack of specificity and limited sensitivities. Cardiac troponin levels but negative CK-MB who were formerly diagnosed with unstable angina or minor myocardial injury is now reclassified as non–ST-segment elevation MI (NSTEMI) even in the absence of diagnostic ECG changes. CK-MB is both a sensitive and specific marker for myocardial infarction. Cardiac troponin T is a cardio-specific, highly sensitive marker for myocardial damage. Cardiac troponin I is a contractile protein exclusively present in the cardiac muscle. The absolute cardiospecificity of cTnI allows the diagnosis of myocardial infarction distinct from muscle lesions and non-cardiac surgery.
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Batta et al. (2022) conducted an observational in Acute Coronary Syndrome (n=155). Cardiac biomarkers (CK-MB subforms, myoglobin, troponins) vs. CK-MB mass (diagnostic standard) was evaluated on Diagnostic sensitivity and specificity for myocardial infarction at 6 hours from symptom onset. CK-MB subforms were the most sensitive early marker for myocardial infarction at 6 hours after symptom onset, exhibiting 91% sensitivity and 89% specificity.
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