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The Impact of Misclassifying an MI
Paul O. Collinson, MD, PhD
Consultant, Chemical Pathologist
Mayday University Hospital Croydon, England
Director, Clinical Biochemistry
Director, Preventative Cardiology Program
St. George's University Teaching Hospital
London, England
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Mass CK-MB: The Old Standard
A commonly used laboratory test to confirm the existence of myocardial damage has traditionally been the measurement of a small fraction of the creatine kinase (CK) enzyme– mass CK-MB (mCK-MB). mCK-MB will not normally be elevated until 6 to 8 hours after the onset of MI.1
Because CK-MB is not specific to the myocardium, noncardiac patients may have measurable CK-MB concentrations from skeletal muscle release. Therefore, in clinical practice, the measurement of Troponin I or T is preferred over the measurment of CK-MB.2 The European Society of Cardiology/American College of Cardiology Guidelines concluded that if Cardiac Troponin assays are not available, CK-MB is the best alternative.
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