Cardiac Marker

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    Cardiac Marker:

           Cardiac marker are biomarkers measured to evaluate heart function.
    Cardiac biomarkers are substance that are released into the blood when the heart is damaged or stressed.
    They are tested when myocardial infraction (MI) is suspected.
    The markers are normally present at all times however, they are significantly elevated during a damage of the heart muscle.
    If MI is suspected, enzyme markers are drawn several times usually 6 hrs apart.
    They are few different enzymes and their levels are elevated hours after the initial heart damage.



    Troponin- Contractile Protein. 
    Two Types- Troponin-T and Troponin-I

        Troponin - T 
            Found in the cardiac marker and skeletal muscle, elevated during Kidney and skeletal muscle damage, early rise after 3-4 hrs. Peak is at 24 hrs.
       
         Troponin - I
             Found only in Cardiac Muscle, more specific out rises, later 4-6 hrs. Peak is at 18 hrs.

    Creatine Phosphokinase (CK-MB)

            Is highly specific test for MI, Elevation of 4% and higher indicate MI.
            The time to rise is 4-6 hrs, Peak is at 24 hrs.

    Lactic Dehydrogenase (LDH)

            There is LDH-1 and LDH-2
            Normally LDH-2 is greater than LDH-1, if LDH-1 is greater than LDH-2 then the person is positive for MI.
            However, LDH-1 increase in level occurs 48-72 hrs, after the onset of symptoms.

    Myoglobin
            
            Is a muscle protein with high sensitivity, but low specificity (can be elevated during other muscle injuries)
            Time of rise is 1-4 hrs.
            Peak is at 6-12 hrs.            



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