Volume 30, Issue 3 (Avicenna Journal of Clinical Medicine-Autumn 2023)                   Avicenna J Clin Med 2023, 30(3): 137-142 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Rastgoo Haghi A, Fariba F, Shamahmoodi S, Moradi A. Diagnostic Value of Cardiac Creatin Kinase and Cardiac Troponin I Measurement in Suspected Myocardial Infarction Patients. Avicenna J Clin Med 2023; 30 (3) :137-142
URL: http://sjh.umsha.ac.ir/article-1-2806-en.html
1- Department of Pathology, School of Medicine, Cardiovascular Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
2- Department of Cardiology, School of Medicine, Cardiovascular Research Center, Hamadan University of Medical Sciences, Hamadan, Iran , farnaz.fariba@gmail.com
3- Cardiovascular Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
4- Department of Social Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
Abstract:   (568 Views)
Background and Objective: Based on previous studies, the clinical sensitivity of cardiac troponin I (cTnI) is higher than creatine kinase MB (CK-MB) in diagnosing acute coronary syndromes. The present study aimed to assess the diagnostic accuracy of cTnI and CK-MB biomarkers in diagnosing suspected myocardial infarction (MI).
Materials and Methods: In this descriptive study, 453 patients suspected of acute coronary syndrome who visited the emergency department of Farshchian Hospital in Hamadan in 2017 with chest pain were included. Of these, 360 patients had MI, and 93 patients did not have MI. In order to measure serum levels of CK-MB and cTnI, blood samples were taken from patients at the beginning and one and six hours later. The sensitivity and specificity of CK-MB and cTnI enzymes in MI were compared.
Results: The sample size of this research was 453 cases, of which 66.45% were male and 33.55% were female. The mean age of subjects was 65.28±14.38 years. The sensitivity and specificity of cTnI in the diagnosis of MI were 96.67% and 100%, respectively. The sensitivity and specificity of CK-MB in diagnosing MI were 81.11% and 12.90%, respectively. The positive and negative predictive values of cTnI were 88.57 and 100, respectively, while the positive and negative predictive values of CK-MB were 78.28 and 15%, respectively. The accuracy of cTnI in differentiating cases of MI from non-MI (97.35%) was higher than that of CKMB (67.08%).
Conclusion: As evidenced by the obtained results, the sensitivity, specificity, and accuracy of cTnI detection in MI cases were higher than CK-MB. Therefore, troponin is a better marker than creatine kinase to identify patients with myocardial infarction.

Full-Text [PDF 633 kb]   (234 Downloads)    
Type of Study: Original | Subject: Cardiovascular Diseases

1. Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, et al. Heart disease and stroke statistics—2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119(3):21-181. PMID: 19075105 DOI: 10.1161/CIRCULATIONAHA.108.191261
2. Adams JE 3rd, Bodor GS, Dávila-Román VG, Delmez JA, Apple FS, Ladenson JH, et al. Cardiac troponin I. A marker with high specificity for cardiac injury. circulation. 1993;88(1):101-106. PMID: 8319322 DOI: 10.1161/01.cir.88.1.101
3. Silverman LM, Mendell JR, Gruemer HD. Creatine-kinase isoenzymes in muscular-dystrophy. In Clinical Chemistry; 1974.
4. Collinson PO. Troponin T or troponin I or CK-MB (or none?). Eur Heart J. 1998;19:16-24. PMID: 9857934
5. Bhagat CI, Langton P, Lewer M, Ching S, Beilby JP. Cardiac troponin I should replace CKMB for the diagnosis of acute myocardial infarction. Ann Clin Biochem. 1997;34(5):511-516. PMID: 9293304 DOI: 10.1177/000456329703400503
6. Wu AH, Feng YJ, Contois JH, Pervaiz S. Comparison of myoglobin, creatine kinase-MB, and cardiac troponin I for diagnosis of acute myocardial infarction. Ann Clin Lab Sci. 1996;26(4):291-300. PMID: 8800429
7. Bertinchant JP, Larue C, Pernel I, Ledermann B, Fabbro-Peray P, Beck L, et al. Release kinetics of serum cardiac troponin I in ischemic myocardial injury. Clin Biochem. 1996;29(6):587-594. PMID: 8939408 DOI: 10.1016/s0009-9120(96)00105-1
8. Ooi DS, Isotalo PA, Veinot JP. Correlation of antemortem serum creatine kinase, creatine kinase-MB, troponin I, and troponin T with cardiac pathology. Clin Chem. 2000;46(3):338-344. PMID: 10702520
9. de Winter RJ, Koster RW, Schotveld JH, Sturk A, van Straalen JP, Sanders GT. Prognostic value of troponin T, myoglobin, and CK-MB mass in patients presenting with chest pain without acute myocardial infarction. Heart. 1996;75(3):235-239. PMID: 8800984 DOI: 10.1136/hrt.75.3.235
10. Santos ES, Baltar VT, Pereira MP, Minuzzo L, Timerman A, Avezum A. Comparison between cardiac troponin I and CK-MB mass in acute coronary syndrome without ST elevation. Arq Bras Cardiol. 2011;96:179-187. PMID: 21308344 DOI: 10.1590/s0066-782x2011005000016
11. Parekh N, Venkatesh B, Cross D, Leditschke A, Atherton J, Miles W, et al. Cardiac troponin I predicts myocardial dysfunction in aneurysmal subarachnoid hemorrhage. J Am Coll Cardiol. 2000;36(4):1328-1335. PMID: 11028491 DOI: 10.1016/s0735-1097(00)00857-3
12. Katus HA, Remppis A, Neumann FJ, Scheffold T, Diederich KW, Vinar G, et al. Diagnostic efficiency of troponin T measurements in acute myocardial infarction. Circulation. 1991;83(3):902-912. PMID: 1999039 DOI: 10.1161/01.cir.83.3.902
13. Aghajani MJK. Diagnostic and prognostic value of cardiac troponin I measurement with qualitative and quantitative methods in acute yocardial infarction and unstable angina. Koomesh. 2002;3(1):89-96.
14. Ikeda J, Zenimoto M, Kita M, Mori M. Usefulness of cardiac troponin I in patients with acute myocardial infarction. Rinsho Byori. 2002;50(10):982-986. PMID: 12451679
15. Shamsi J, Yaghmaei P, Seyed MM, Haeri RS. Investigation of the level of serum troponin i and comparing it with serum ck-mb in diagnosis of myocardial infarction. Anim Biol J. 2015;7(4).
16. Peela J, Jarari A, Hai A, Rawal A, Kolla S, Sreekumar S, et al. Cardiac biomarkers: the troponins and CK-MB. IJMBS. 2010;2(05):190-197. DOI:10.4103/1947-489X.210998
17. Singh G, Baweja PS. Creatine Kinase–MB: the journey to Obsolescence. Am J Clin Pathol. 2014;141(3):415-419. PMID: 24515770 DOI: 10.1309/AJCPBIK3G4BWEJKO
18. Novack V, Jotkowitz AB, Cutlip D, Amit G, Liebermann N, Porath A. Transition from CK-MB to troponin did not improve the 1 year mortality of non-ST elevation acute coronary syndromes. Postgrad Med J. 2008;84(987):50–55. PMID: 18230752 DOI: 10.1136/pgmj.2007.062018
19. Collinson PO, Stubbs PJ, Kessler AC; Multicentre evaluation of routine immunoassay of troponin T study. Multicentre evaluation of the diagnostic value of cardiac troponin T, CK-MB mass, and myoglobin for assessing patients with suspected acute coronary syndromes in routine clinical practice. Heart. 2003;89(3):280-6. PMID: 12591831 DOI: 10.1136/heart.89.3.280

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Avicenna Journal of Clinical Medicine

Designed & Developed by : Yektaweb