This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Go to /pro/cpd-dashboard page

This page is worth 0.05 CPD credits. CPD dashboard

Go to /account/subscription-details page

This page is worth 0.05 CPD credits. Upgrade to Pro

Cardiac markers

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Cardiac enzymes are molecules released into the circulation as a consequence of cardiac injury. They are used in the diagnosis of myocardial infarction, but elevations are not synonymous with an ischaemic mechanism of injury and results should be interpreted in the context of clinical and ECG findings.

It is important to note that cardiac enzymes such as creatine kinase (CK), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) are of variable specificity to cardiac muscle.

Cardiac Troponins T and I are the preferred markers for the diagnosis of myocardial injury. These markers are more sensitive and more specific than measuring CK, AST or LDH. Some authorities believe that these latter assays should no longer be used to evaluate cardiovascular disease. It is accepted however that total CK may have a role in trials to allow comparison with previous data and also that CK-MB measurement may help clarify whether a cardiac event has occurred within the preceding 48 hours.

Cardiac enzymes include:

  • cardiac Troponin T and I, CK - earliest to rise
  • AST - second to rise
  • LDH - latest to rise

Peaks tend to occur earlier and are often higher, following successful thrombolytic therapy. This is attributed to the "washout" of enzymes from the infarcted area immediately after reperfusion occurs.


Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.