The troponin I/ myoglobin/creatine kinase isoenzyme (cTnI/ Myo /CK-MB) includes the following three indicators: The combined detection of troponin I (cTnI), myoglobin (Myo) and creatine kinase isoenzyme (CK-MB) is of great significance in the early diagnosis of acute myocardial diseases such as AMI
American Academy of Clinical Biochemistry (NACB) practice guidelines
All suspected patients with ACS should be tested for markers of myocardial necrosis
Troponin is the primary marker for the diagnosis of myocardial infarction
Myoglobin in combination with specific markers of myocardial necrosis, such as cTnI/CK-MB, may help to rule out or diagnose myocardial infarction more quickly
MYO | CK-MB | cTnI | |
molecular weight | 17.8KD | 86KD | 22.5KD |
Rise time | 1-2h | 4-6h | 3-6h |
Peak time | 6-9h | 24h | 12-16h |
recovery time | 18-30h | 2-3d | 4-10d |
Clinical value | 1. The most important index of AMI was excluded in the early stage 2. Recurrent diagnosis of AMI, and the best evaluation index of reperfusion treatment effect | 1. Estimate infarct size or reinfarct 2. The most valuable non-ST segment elevation marker of MI | 1. Preferred markers for the diagnosis of AMI 2. Judge the infarct size and risk stratification |
Detection range | sample size | Sample type | Test time | ||
cTnI | MYO | CK-MB | 60μl | Whole blood / serum / plasma | 15min |
0.1~50ng/mL | 10~200ng/mL | 0.8~100ng/mL |
Possibility of outcome | |||
cTnI | CK-MB | MYO | Clinical possibility |
+ | + | + | Myocardial infarction/myocardial injury can be diagnosed basically, and the occurrence time is 12-24 hours; |
+ | + | - | It can be basically diagnosed as myocardial infarction/myocardial injury, and the detection time is more than 1 day, which has passed the detection window period of Myo. |
+ | - | - | Myocardial infarction/myocardial injury has occurred for 2-3 days, and it is recommended to check again several hours later. |
+ | - | + | In patients with myocardial infarction/myocardial injury, the detection time may be longer than 3 days for symptoms, and patients suffer from reinjury or infarction size enlargement; |
- | + | + | Early myocardial infarction/myocardial injury/muscle injury, cTnI reexamination is recommended within 4-8 hours; |
- | - | + | 1. Early myocardial infarction/myocardial injury, cTnI reexamination is recommended within 4-8 hours; |
2. It may be caused by other injury diseases, such as creative work, skeletal muscle injury, liver and kidney disease; | |||
- | + | - | 1. For minor myocardial injury, it is recommended to reexamine cTnI within 4-8 hours; |
2. It may be non-myocardial injury disease, and the detection time has passed the Myo window period; | |||
- | - | - | Myocardial infarction/myocardial injury is basically ruled out. If highly suspected, it is recommended to check every 2 to 4 hours. |
Outpatient, emergency, physical examination center, cardiovascular, ICU, chest pain center and other departments
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