• Karri Penttilä, Heli Koukkunen, Matti Halinen, Tapio Rantanen, Kalevi Pyörälä, Kari Punnonen, and Ilkka Penttilä.
• Department of Clinical Chemistry, Kuopio University Hospital, Kuopio, Finland. karri.penttila@kuh.fi
• Clin. Biochem. 2002 Nov 1; 35 (8): 647-53.

ObjectivesMeasurements of myoglobin and creatine kinase (CK)-MB isoforms have been suggested to be sensitive tests for the early diagnosis of myocardial infarction (MI). We have investigated the utility of myoglobin, creatine kinase (CK)-MB isoforms and creatine kinase MB mass (CK-MBm) in early diagnosis of MI using cardiac troponin T (cTnT) positivity as a reference.Design And MethodsThe study population comprised 440 patients who had had chest pain for less than 12 h. Patients were divided into cTnT negative (cTnT-) or cTnT positive (cTnT+) patients (concentration of cTnT >0.1 microg/L at two different time points during 72 h).ResultsAt the time of admission to the emergency department receiver operating characteristics (ROC) curves of CK-MB isoforms and CK-MBm were not better than that of myoglobin. Six hours after admission CK-MB isoforms and CK-MBm provided statistically significantly larger areas under the curve (AUC) than myoglobin (p < 0.01). When ROC curves were related to the onset of chest pain (< 3 h, 3-6 h, and > 6 h) there were no significant differences between the cardiac markers studied.ConclusionsAccording to the present findings, CK-MB isoforms or myoglobin offer no advantage over CK-MBm as early markers of myocardial infarction.Copyright 2002 The Canadian Society of Clinical Chemists

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