Cardiac biomarkers: The troponins and CK- MB

With the prevalence of ischemic heart disease, early diagnosis and management of myocardial infarction is important, and necessitates the need for cardiac biomarkers. Since several markers have evolved over time, it becomes important to understand which markers are best in different clinical situations. After a review of the literature, we have summarized the most frequent markers used. Though the search for an ideal cardiac biomarker remains, troponins seem to have evolved as the most advantageous. Features of troponins include high specificity, sensitivity, a wide diagnostic window allowing prompt, early diagnosis, as well as enhancing detection of myocardial injury in patients presenting late. Enabling risk stratification, estimation of infarct size, detecting reperfusion, usefulness in predicting prognostic outcomes, and offering therapeutic guidance also are among the advantageous features of troponins. Troponins also aid in detecting perioperative myocardial injuries and cardiac injury in renal failure patients. CK myocardial band (CK-MB), however, seems to be more advantageous in detecting reinfarction, though it has limitations in terms of early diagnosis. Troponins are being increasingly used, compared to other cardiac biomarkers, in the detection of acute coronary events and myocardial damage, though CK-MB is still preferred in selective situations.