Cardiovascular

Protocols

Troponin-I:

Indications For Troponin-I

  1. This test is advised to rule out myocardial infarction (MI) in a patient with chest pain.
  2. This is a specific indicator of cardiac damage or infarction.
  3. This helps diagnose MI at an early stage.
  4. This test is done for the early diagnosis of myocardial infarction.

The pattern of Troponin-T in acute myocardial infarction:

  1. Raised even in the first 3 hours.
  2. The peak level is 12 to 48 hours.
  3. Remain elevated for up to 10 to 14 days.

Positive Or Raised Troponin-T Level Was Seen In:

  1. Acute myocardial infarction.
  2. Pre-Surgical myocardial infarction.
  3. Unstable angina.
  4. Non-ischemic diseases of the heart:
    1. Acute trauma involving muscles.
    2. Rhabdomyolysis.
    3. Polymyositis.
    4. Dermatomyositis.
    5. Chronic renal failure.
    6. Myocarditis.
    7. Pericarditis.
    8. Heart failure.
    9. Pulmonary embolism.
    10. Sepsis.
    11. Shock.
    12. Renal insufficiency.


    MarkerDetectablePeak levelReturn to normal
    Troponin-T4 to 8 hours12 to 48 hours7 to 10 days
    Troponin- I4 to 6 hours12 hours3 to 10 days
    CK-MB4 to 8 hours12 to 24 hours72 to 96 hours
    LDH2 to 5 days10 days

    CK-MB When Begins To Rise And Interpretations:

    1. CK-MB begins to rise 3 to 6 hours after the onset of Acute Myocardial infarction (AMI).
    2. The peak is between 12 to 24 hours.
    3. It returns to normal in 24 to 48 hours.


    CK-MB May Be Raised In:

    1. Acute myocardial infarction.
    2. Cardiac aneurysmal surgery.
    3. Myocarditis.
    4. Ventricular arrhythmias.
    5. Duchenne’s muscular dystrophy.
    6. Patients with gangrene or severe ischemia of the limbs.
    7. Acute myositis of various types.
    8. Athletes who are long race runners.
    9. Idiopathic myoglobinemia.
    10. Reye’s syndrome.
    11. Rocky-spotted mountain fever.
    EnzymeStart to rise hoursPeak (hours)    Days to normal
    CK-MB4182
    Total CPK4  to 6243  to  4
    Troponin T4  to  610  to  2410
    Troponin I4  to  610  to  244
    LDH24728 – 9
    SGOT824  to  484