Cardiac Panel

(Myoglobin, CK-MB, Troponon I)

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Cardiac troponin I (cTnI) is a cardiac muscle protein with a molecular weight of 22.5 kilodaltons. Together with troponin T (TnT) and troponin C (TnC), TnI forms a troponin complex in heart to play a fundamental role in the transmission of intracellular calcium signal actin-myosin interaction. The human cTnI has an additional amino acid residues on its N-terminal that are not exist on the skeletal forms thus making cTnI a specific marker for indicating cardiac infarction. cTnI is released rapidly into blood after the onset of acute myocardial infarction (AMI). Its release pattern is similar to CK-MB (4-6 hours after the onset of AMI). However, CK-MB level returns to normal after 36-48 hours, while levels of cTnI remains elevated for up to 6-10 days. The level of cTnI is very low in normal healthy people, and not detected in patients with skeletal muscle injury. Therefore, cTnI is a specific marker for diagnosis of acute myocardial infarction.

Creatine kinase is a dimer occurring in various in three isoenzymic forms, depending on the particular combination of its non-identical subunits:BB(brain type);MM(skeletal type); and MB(hybrid type). Creatine kinase-MB isoenzyme is released into circulation later than myoglubin, reaching abnormal levels within 4 to 6 hours after onset of symptoms, it reaches its highest level with a typical range of 39-185 ng/mL after about 18 to 24 hours, and returns to normal in about 2 to 3 days. CK-MB is widely recognized as the traditional marker for the diagnosis of AMI.

Myoglobin is a low molecular weight, cytoplasmic serum protein. Due to its low molecular weight, myoglobin is released more rapidly when muscle cells are damaged than other markers. Serum concentration of myoglobin increases above the normal range as early as 1 hour after myocardial infarction, and peak in approximately 4 to 8 hours after onset. Therefore, myoglobin is better suited for the early diagnosis of AMI.

Quick Profile™ Cardiac Panel test is a sandwich immunoassay. When serum sample is added to sample pad, it moves through the conjugate pad and mobilizes gold antibody conjugate that is coated on the conjugate pad. The mixture moves along the membrane by capillary action and reacts with anti-cardiac marker antibodies that is coated on the test region. If cardiac markers are present at levels of cut-off level or greater, the result is the formation of a colored band in the test region. If there are no cardiac markers in the sample, the area will remain colorless. The sample continues to move to the control area and forms a pink to purple color, indicating the test is working and the result is valid.

Below are the cut-off concentrations for each cardiac marker using in the test.

Troponin I 1.0 ng/mL

CK-MB 7.0 ng/mL

Myoglobin 100 ng/mL

If after 15 minutes, you see one of the following results. It may imply the indicated syndrome.

a) MYG-positive/CKMB-positive/TnI-positive
(MYO ≥ 100 ng/mL, CK-MB ≥ 7.0 ng/mL, Tn I ≥ 1.0ng/mL)
Myocardial cell necrosis within the past 12 hours.

b) MYG-positive/CKMB-positive/TnI-negative
(MYO ≥ 100 ng/mL, CK-MB ≥ 7.0 ng/mL, Tn I < 1.0ng/mL)
Early muscle or cardiac injury. Serial Troponin I testing is suggested in 4 & 8 hrs to rule in acute coronary syndrome

c) MYG-negative/CKMB-positive/TnI-positive
(MYO < l00 ng/mL, CK-MB ≥ 7.0 ng/mL, Tn I ≥ 1.0ng/mL)
Acute myocardial infarction post 12 hours from the onset of early symptoms

d) MYG-negative/CKMB-positive/TnI-negative
(MYO <.100 ng/mL, CK-MB ≥ 7.0 ng/mL, Tn I < 1.0ng/mL)
Early muscle or cardiac injury. Serial Troponin I testing is suggested in 4 & 8 hrs to rule in acute coronary syndrome.

e) MYG-negative/CKMB-negative/TnI-positive
(MYO < l00 ng/mL, CK-MB < 7.5 ng/mL, Tn I ≥ 1.0ng/mL)
Acute myocardial infarction post 24-96 hours

f) MYG-positive/CKMB-negative/TnI-negative
(MYO ≥ l00 ng/mL, CK-MB < 7.5 ng/mL, Tn I < 1.0ng/mL)
Early muscle or cardiac injury. Serial Troponin I testing is suggested in 4 & 8 hrs to rule in acute coronary syndrome. (MYO ≥ l00 ng/mL, CK-MB < 7.5 ng/mL, Tn I < 1.0ng/mL).

g) MYG-positive/CKMB-negative/TnI-positive
(MYO ≥ l00 ng/mL, CK-MB < 7.5 ng/mL, Tn I ≥ 1.0ng/mL).
A very possible myocardial cell necrosis

h) MYG-negative/CKMB-negative/TnI-negative
(MYO < l00 ng/mL CK-MB < 7.5 ng/mL, Tn I < 1.0 ng/mL)
Acute myocardial infarction may not happen. If the cardiac injury is suspected, retest in 2 - 4 hours.

 

QuickProfile Cardiac Panel (Whole Blood)

Kit Catalogue Number
25 slides MP75004

 

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Metachem Diagnostics Ltd.
29 Forest Road, Piddington, Northampton. NN7 2DA
Tel. (01604) 870370     Fax (01604) 870194