Cardiac enzymes
Markers
Cardiac Enzymes Over Time
| Type | Interval (hours) | Peak Elevation (hours) | Return to Normal |
| Myoglobin | 1-4 | 6-7 | 18-24 hours |
| Troponin I | 3-12 | 10-24 | 3-10 days |
| Troponin T | 3-12 | 10-24 | 5-14 days |
| CK-MB | 4-12 | 12-24 | 2-3 days |
| LDH | 8-12 | 24-48 | 10-14 days |
- n I - 2-4 hrs 1st detect
- 8-12 hrs w/100% sensitivity
- 10-24 peak
- 5-10 day duration
- Tn T - above plus 5-14 d duration
- CK-MB : 3-4
- 8-12 (100% sensitive)
- 10-24 hr peak</font></font></span>
- MYOGLOBIN : 1-2 hrs detect first
- 4-8 100% sens
- 4-8 peak
- 0.5-1.0 duration
- 2-4 day duration</font></font></span>
Creatine Phosphokinase
- can be elevated in trauma, rhabdo, hyperthermia, physical activity, renal or endocrine dz, systemic infections
- if pt small with small muscle mass to begin with, total ck may not be elevated- so better to use ck index- is ratio of ckmb/ total ck. Elevated if > 3- 5%.
- CK Mass: with monoclonal antibody techniques, can directly measure ck mb mass as mmcg/L. More sensitive for detection of ami