The Specificity of Biochemical Markers of Cardiac Damage: a Problem Solved
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Fred S. Apple
Abstract
This paper reviews the tissue specificity of cardiac troponin I (cTnI), cardiac troponin T (cTnT) and creatine kinase (CK) MB in human and animal heart and skeletal muscles. Studies reveal that CK-MB can be expressed up to 20% of total CK activity in human skeletal muscle; and therefore is not 100% specific for the heart. One cTnI isoform has been described and shown to be 100% specific for the heart. While one to four cTnT isoforms are expressed in diseased and regenerating human skeletal muscle, these isoforms are not the same as the cTnT isoforms expressed in the human heart and are not detected by the cTnT diagnostic assays used in clinical practice. Representative cases are described demonstrating the role of monitoring cardiac troponins in blood for differentiating false positive CK-MB increases due to skeletal muscle injury. Further, sufficient reactivity and tissue specificity of cTnI and cTnT assays are demonstrated for use as markers of myocardial injury in laboratory animals. Monitoring cTnI and cTnT concentrations in the circulation appears poised as the new standards for detection of myocardial injury.
Copyright © 1999 by Walter de Gruyter GmbH & Co. KG
Artikel in diesem Heft
- Author Index
- Contents
- Subject Index
- Strategies for Cardiac Marker Measurement
- Statistical Techniques for Evaluating the Diagnostic Utility of Laboratory Tests
- Magnesium in Disease: a Review with Special Emphasis on the Serum Ionized Magnesium
- Methods for Improving Clinical Trials
- Infrared Analysis of Urinary Stones: a Trial of Automated Identification
- Evaluation of a Direct α-Amylase Assay Using 2-Chloro-4-nitrophenyl-α-D-maltotrioside
- Accurate Platelet Counting in an Insidious Case of Pseudothrombocytopenia
- A New Liquid Homogeneous Assay for HDL Cholesterol Determination Evaluated in Seven Laboratories in Europe and the United States
- Tissue Release of Cardiac Markers: from Physiology to Clinical Applications
- The Specificity of Biochemical Markers of Cardiac Damage: a Problem Solved
- Biochemical Factors Influencing Measurement of Cardiac Troponin I in Serum
- The Sensitivity of Cardiac Markers: an Evidence-based Approach
- Risk Stratification and Therapeutic Decision Making in Patients with Acute Coronary Syndromes the Role of Cardiac Troponin T
- Cardiac Markers: Centralized or Decentralized Testing?
- EC4 European Syllabus for Post-Graduate Training in Clinical Chemistry. Version 2 – 1999
- Plasma Malondialdehyde and Obesity: Is there a Relationship?
- Reference Intervals: Are Interlaboratory Differences Appropriate?
- Lipoprotein Protocols. By J.M. Ordovas, editor
- Tietz Textbook of Clinical Chemistry. By C.A. Burtis and E.R. Ashwood, editors
Artikel in diesem Heft
- Author Index
- Contents
- Subject Index
- Strategies for Cardiac Marker Measurement
- Statistical Techniques for Evaluating the Diagnostic Utility of Laboratory Tests
- Magnesium in Disease: a Review with Special Emphasis on the Serum Ionized Magnesium
- Methods for Improving Clinical Trials
- Infrared Analysis of Urinary Stones: a Trial of Automated Identification
- Evaluation of a Direct α-Amylase Assay Using 2-Chloro-4-nitrophenyl-α-D-maltotrioside
- Accurate Platelet Counting in an Insidious Case of Pseudothrombocytopenia
- A New Liquid Homogeneous Assay for HDL Cholesterol Determination Evaluated in Seven Laboratories in Europe and the United States
- Tissue Release of Cardiac Markers: from Physiology to Clinical Applications
- The Specificity of Biochemical Markers of Cardiac Damage: a Problem Solved
- Biochemical Factors Influencing Measurement of Cardiac Troponin I in Serum
- The Sensitivity of Cardiac Markers: an Evidence-based Approach
- Risk Stratification and Therapeutic Decision Making in Patients with Acute Coronary Syndromes the Role of Cardiac Troponin T
- Cardiac Markers: Centralized or Decentralized Testing?
- EC4 European Syllabus for Post-Graduate Training in Clinical Chemistry. Version 2 – 1999
- Plasma Malondialdehyde and Obesity: Is there a Relationship?
- Reference Intervals: Are Interlaboratory Differences Appropriate?
- Lipoprotein Protocols. By J.M. Ordovas, editor
- Tietz Textbook of Clinical Chemistry. By C.A. Burtis and E.R. Ashwood, editors
