Skip to main content
SpringerLink
Log in

Diagnosis of acute myocardial infarction: CK-MB versus cTn-T in Indian patients

  • Published:
Indian Journal of Clinical Biochemistry Aims and scope Submit manuscript

Abstract

The comparative diagnostic efficacy of two cardiac markers: CK-MB and cTn-T, has scarcely been investigated in Indian patients of acute myocardial infarction. The present study was conducted for the same objective. The present study comprised of 59 patients. Males were 44 (75%) and females were 15 (25 %). The age of patients ranged from 32–84 years with mean age of 62.8 yrs. The mean age of males and females were 60 and 63 yrs respectively. All patients presented with history of chest pain with a 12 leads ECG proven MI (ST Elevation, discordant T-waves). CK-MB was estimated in peripheral blood samples at 0,24,48 and 72 hours by an autoanalyzer. Following 12 hours of admission bed side Troponin-T test was done employing cTn-T marker kit. Initially (0 hr), in 50% patients CK-MB was elevated. By end of 24 hours all the patients were CKMB positive and peak level was attained at 24 hrs. Then it tended to decline over next 48 hrs. There were no false positive or negative results. The cTn-T test was positive only in 22 % of ECG positive infarctions. However, the cTn-T positive cases were always accompanied by a higher CK-MB levels. A significantly lower cTn-T positive cases in Indian patients can only be attributed to some difference in amino acid sequence of Indian cTn-T and occidental cTn-T. A larger study from other Indian cardiac centers can either substantiate or contradict our results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Plebani M, Laninollo M. Cardiac markers present and future. Inter J Clin Lab Res 1999; 29(2): 56–63.

    Article  CAS  Google Scholar 

  2. Dhawan J, Petkar S. Epidemiology of coronary artery disease in south east Asians. Current Sciences 1998;74: 1060–1063.

    Google Scholar 

  3. Enas AE. High rates of CAD in Asian Indian in the united states despite intense modification of life style, what next? Current Sciences 1998;74(12): 1081–1086.

    Google Scholar 

  4. Mohanti D, Shetti S, Anil CR, Patkere A, Ghosh K, Yeotekar ME. Factor V leiden gene mutation in young Indian patients with myocardial infarction. Current Sciences 1998;74(12):1078–1080.

    Google Scholar 

  5. Bhatnagar D. The metabolic basis of increased coronary risk attributed to people from the Indian subcontinent. Current Sciences1998;74(12):1087–1094.

    Google Scholar 

  6. Saxena KK, Gupta B, Srivastava VK, Saxena RS, Singh RC, Prasad DN. Creatine kinase and aspartate transaminase in experimental model to predict the size of cardiac infarct. Ind J Exp Biol 1988;26: 235–236.

    CAS  Google Scholar 

  7. Levinson SS, Hobbs GA. Usefulness of various lactate dehydrogenase isoenzyme 1 profiles after myocardial infarction. Ann Clin Lab Sci 1994;24:364–370.

    PubMed  CAS  Google Scholar 

  8. Hossein-Nia M, Kallis P, Brown PA, Chesfer MR, Kaski JC, Murday AT, et al. Creatine kinase MB isoforms: sensitive markers of ischemic myocardial damage. Clin Chem 1994;40:1265–1271.

    PubMed  CAS  Google Scholar 

  9. Khaw BA, Gold HK, Fallon JT, Haber E. Detection of serum cardiac myosin light chains in acute experimental myocardial infarction: radioimmunoassay of cardiac myosin light chains. Circulation 1978;58:1130–1136.

    PubMed  CAS  Google Scholar 

  10. Trahern CA, Gere JB, Krauth GH, Brigham DA. Clinical assessment by serum myosin light chain in the diagnosis of myocardial infarction. Am J Cardiol 1978; 4: 641–645.

    Article  Google Scholar 

  11. Katus HA, Deiderich KW, Hobergs E, Kubler W. Circulating cardiac myosin light chains in patients with angina at rest. Identification of a high risk subgroup. Am Coll Cardiol 1988 11: 487–493.

    Article  CAS  Google Scholar 

  12. Toyo-oka T, John Ross J Jr. Calcium sensitivity change and troponin loss in cardiac natural actomyosin after acute coronary occlusion. Am J Physiol 1981; 240 (Heart Circ Physiol 9):740 H–748 H.

  13. Decker RS, Poole AR, Griffin EE, Dingle JT, Wildenthal K. Altered distribution of lysosomal cathepsin D in ischemic myocardium. J Clin invest 1977;30:911–921.

    Article  Google Scholar 

  14. Noda Takashu, Isagai K, Hayashi H, Katanuma N. Susceptibility of various myofibrillar protein to cathepsin B and morphological alternation of isolated myofibrills to this enzyme. J Biochem 1981;90:371–379.

    PubMed  CAS  Google Scholar 

  15. Srivastava RD, Blanchard EM, Solaro RJ. Unpublished observation 1981, Department of Physiology, College of Medicine, University of Cincinnati, Ohio, USA.

    Google Scholar 

  16. Srivastava RD, Blanchard EM, Solaro RJ. Early contractile protein and SR dysfunction in dog heart following invitro ischemia. In: International symposium workshop calcium channel blocker and heart. Held at Department of Pharmacology, All India Institute of Medical Sciences October 20–21, 1986 Abstract.

  17. Katus HA, Remppis A, Scheffold T, Diederich KW, Kubler W. Intracellular compartmentisation of c Tn-T and its release kinetics in patient with reperfusion non reperfusion myocardial infarction. Am J Cardiol 1991; 67: 1360–1367.

    Article  PubMed  CAS  Google Scholar 

  18. Bordorff MM, Fretag Helmut, Sceffold T, Remppis A, Kubler W, Katus HA. Development and characterisation of rapid assay for bed side determination of cardiac troponin T. Circulation 1995; 92:2869.

    Google Scholar 

  19. Antman EM, Braunwald E. Acute myocardial Infarction. In: Heart Disease: A text book of cardiac medicine.: Laboratory examinations: Markers of cardiac damage, eds Braunwald E, Zipes DP, Libby P edn. 6th chapter 35. W B Saunders 2001 Philadelphia PP 1131–1135.

  20. Hamm CW. New serum markers for acute myocardial Infarction. New Eng J Med 1994;331:607–608.

    Article  PubMed  CAS  Google Scholar 

  21. Reddy GC, Kusumanjali G, Sharda AHR, Rao P. Cardiac troponin-T and CK-MB (Mass) levels in Cardiac and non Cardiac disease. Ind J Clin Biochem 2004;19(2): 91–94.

    Article  CAS  Google Scholar 

  22. Zarich SW, Qamar AU, Werdmann MJ, Lizak LS, Mc Pherson CA, Bernstein LH. Value of a single troponin-T at the time of presentation as compared to serial CK-MB determinations in patients with suspected myocardial ischemia. Clin Chim Acta 2002;326:185–192.

    Article  PubMed  CAS  Google Scholar 

  23. Muller-Bordorff M, Rauscher T, Kampmann M, Schoolmann S, Lufenburg F, Mangold D, Zerback R, Rempiss A, Katus HA. Qualitative bed side assay for cardiac troponin-T: a complementary method to centralized laboratory testing. Clin Chem 1999; 45(7): 1002–1008.

    Google Scholar 

  24. Ganong WF. Circulating body fluid. In: Review of medical Physiology Edition 21, Mc Graw-Hill, New York 2003, P 538.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Physiology, MLN Medical College, C/o Mrs. Priti Gupta 403/Type 4, M.L.N. Medical College Campus, Allahabad, India

    Sanjiv Gupta, K. N. Singh, V. Bapat, V. Mishra & P. Gupta

  2. Division of Cardiology of Medicine SRN Hospital, MLN Medical College, C/o Mrs. Priti Gupta 403/Type 4, M.L.N. Medical College Campus, Allahabad, India

    D. K. Agarwal

Authors
  1. Sanjiv Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. N. Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. V. Bapat
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. V. Mishra
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. K. Agarwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. P. Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sanjiv Gupta.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gupta, S., Singh, K.N., Bapat, V. et al. Diagnosis of acute myocardial infarction: CK-MB versus cTn-T in Indian patients. Indian J Clin Biochem 23, 89–91 (2008). https://doi.org/10.1007/s12291-008-0021-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12291-008-0021-7

Key Words

Search

Navigation