Improved Specificity of Myoglobin Plus Carbonic Anhydrase Assay Versus That of Creatine Kinase-MB for Early Diagnosis of Acute Myocardial Infarction

Brogan, Gerard X.; Vuori, J.; Friedman, Solomon; McCuskey, Charles F.; Thode, Henry C.; Väänänen, H. Kalervo; Cooling, David S; Bock, Jay L.

doi:10.1016/s0196-0644(96)70291-3

Cited by 36 publications

(6 citation statements)

References 25 publications

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“…Accordingly, H-FABP showed the lowest − LH (0.18), and cTnI showed the highest + LH (24.64). In our study, the MYO/CA III best cutoff (1.73) had a higher sensitivity (MYO/CA III = 78.6% vs. MYO = 71.4%) but a lower specificity (MYO/CA III = 83.3% vs. MYO = 94.4%) than MYO, differently from the data reported in different papers [20][21][22][23][24]. Table 4 shows results obtained after combining the most specific marker (cTnI) with each one of the other markers studied, and evaluating the sensitivity and specificity of these different "two-marker strategies".…”

Section: Resultscontrasting

confidence: 99%

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Analytical and clinical performance of a fully automated cardiac multi-markers strategy based on protein biochip microarray technology

Mion

Novello

Altinier

et al. 2007

Clinical Biochemistry

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Section: Resultscontrasting

confidence: 99%

“…Several papers have shown the utility of combining CA III with MYO measurements in the presence of high plasma MYO concentrations: the plasma MYO/CA III ratio may indicate the tissue source of MYO, thus enhancing the specificity of MYO and confirming a diagnosis of AMI [20][21][22][23], also in patients with renal failure [24].…”

Section: Introductionmentioning

confidence: 99%

Analytical and clinical performance of a fully automated cardiac multi-markers strategy based on protein biochip microarray technology

Mion

Novello

Altinier

et al. 2007

Clinical Biochemistry

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“…[12][13][14] Since skeletal and cardiac muscle myoglobins are indistinguishable, increased skeletal muscle myoglobin release due to a variety of medical conditions or lack of adequate renal clearance may cause a ''false-positive'' myoglobin test. 39,40 Indeed, our results confirm that the specificity of myoglobin (81.9% [95% CI = 38.6 to 62.9]) for the prediction of AEs is significantly lower than that of either cTnT (93.1% [95% CI = 90.3 to 95.8]) or CK-MB (99.7% [95% CI = 99.1 to 100.0]).…”

Section: The ''Clinical Specificity'' Of Myoglobinsupporting

confidence: 76%

Myoglobin for Early Risk Stratification of Emergency Department Patients with Possible Myocardial Ischemia

Green

Skarbek-Borowski

Chan

et al. 2000

Academic Emergency Medicine

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Abstract. Objectives: To determine and compare the prognostic abilities of early, single-sample myoglobin measurement with that of creatine kinase-MB (CK-MB), with cardiac troponin T (cTnT), and with physician judgment in the absence of marker results among emergency department (ED) patients with possible myocardial ischemia. Methods: Prospective collection of clinical and serologic data using an identity-unlinked technique from patients with possible myocardial ischemia at two urban EDs. Outcome data concerning the occurrence of adverse events (AEs) during the 14 days after enrollment were used to calculate and compare the relative risks (RRs) Conclusions:The early prognostic sensitivity of myoglobin may allow identification of some high-risk patients missed by physician judgment, CK-MB, and cTnT. Myoglobin should be considered for use in the ED based on both its diagnostic and prognostic abilities.

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“…Additional mark ers are emerging such as myoglobin, rapid CK-MB. and CK-MB isoforms as earlier markers of AMI than CK-MB mass [15][16][17][18], Assays for subunits of the troponin com plex using cardiac-specific antibodies have been reported as equally sensitive and possibly more specific than CK-MB for detecting acute myocardial injury [19. 21] in the presence of skeletal muscle damage [22][23][24],…”

Section: Discussionmentioning

confidence: 99%

Elevated Serum Cardiac Markers in Asymptomatic Marathon Runners after Competition: Is the Myocardium Stunned?

et al. 1997

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Prolonged strenuous exercise may trigger acute myocardial infarction (AMI), as exemplified by the occurrence of sudden cardiac death during marathon running. Serum creatine kinase MB (CK-MB) may be elevated in asymptomatic marathon runners after competition from exertional rhabdomyolysis of skeletal muscle altered by training, limiting its utility for evaluating acute cardiac injury in such athletes. Myoglobin and CK-MB2 isoform levels are emerging as earlier markers of AMI and troponin subunits as more specific than serum CK-MB mass. We tested runners before and sequentially after the 1995 Boston Marathon for conventional and newer markers including myoglobin, CK-MB mass and isoforms, cardiac troponin T, and cardiac troponin I using standard laboratory methods and rapid format assays if available. The mean serum values for myoglobin, CK-MB mass, CK-MB/myoglobin rapid panel tests, and CK-MB2 isoforms were normal or negative pre-race and elevated or positive 4 and 24 h after competition. These markers lack specificity for acute cardiac injury in trained runners. While the mean serum values for cardiac troponins T and I remained normal, 9 of 45 runners (20%) showed an increase in subunits by first-generation assays. All runners remained asymptomatic for cardiac disease and completed subsequent marathons 1 year later, making reversible myocardial injury or stunning unlikely. Elevated values of serum markers for AMI, including first-generation assays for both troponin subunits should be interpreted with caution in trained runners.

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Improved Specificity of Myoglobin Plus Carbonic Anhydrase Assay Versus That of Creatine Kinase-MB for Early Diagnosis of Acute Myocardial Infarction

Cited by 36 publications

References 25 publications

Analytical and clinical performance of a fully automated cardiac multi-markers strategy based on protein biochip microarray technology

Analytical and clinical performance of a fully automated cardiac multi-markers strategy based on protein biochip microarray technology

Myoglobin for Early Risk Stratification of Emergency Department Patients with Possible Myocardial Ischemia

Elevated Serum Cardiac Markers in Asymptomatic Marathon Runners after Competition: Is the Myocardium Stunned?

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