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Clinical Chemistry 43: 2047-2051, 1997;
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(Clinical Chemistry. 1997;43:2047-2051.)
© 1997 American Association for Clinical Chemistry, Inc.

Articles

Improved detection of minor ischemic myocardial injury with measurement of serum cardiac troponin I

Fred S. Applea, Alireza Falahati, Pamela R. Paulsen, Elizabeth A. Miller and Scott W. Sharkey1

1 Current address: Minneapolis Cardiology Associates, 1515 St. Frances Ave., Shakopee, MN 55379.
a Author for correspondence. Fax 612-904-4229; e-mail fred.apple{at}co hennepin.mn.us.

This study compared the diagnostic accuracy of the measurement of serum cardiac troponin I (cTnI) with creatine kinase (CK) MB mass in patients with minor myocardial injury whose measured total CK activity did not exceed twice the upper reference limit (300 U/L for men; 200 U/L for women). Forty-eight consecutive patients presenting with chest pain and with in-hospital documentation of myocardial injury were enrolled. Electrocardiogram, echocardiogram, and serial serum CK-MB mass, cTnI, and total CK were measured over 36 h after admission. Peak total CK activity was within normal limits in 28 patients (58%). The mean (±SD) peak CK-MB mass and cTnI concentrations were: 16.4 (11.8) µg/L and 132 (13.0) µg/L; respectively. The peak biochemical marker index (defined as CK-MB or cTnI divided by its respective upper reference limit) was significantly (P <0.05) higher for cTnI than for CK-MB from 7 to 36 h. The clinical sensitivity for detection of myocardial injury for cTnI was 100% [95% confidence interval (CI): 87.2% to 100%], compared with 81.8% (CI: 67.3% to 91.8%) for CK-MB. Thus, cTnI was more sensitive than CK-MB mass for detection of myocardial injury in patients with small increases of total CK.




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