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Cardiac Biomarkers

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Summary Tables

The following tables summarize currently used cardiac biomarkers.

Cardiac Biomarker Tests

These tests are used to help diagnose, evaluate, and monitor people suspected of having Acute Coronary Syndrome (ACS).
Marker what it is
Tissue source Reason for Increase
Time to Increase Time Back to Normal
When/How Used
Cardiac Troponin Regulatory protein complex; two cardiac-specific isoforms: T and I Heart Injury to heart 2 to 8 hours Remains elevated for 7 to 14 days Diagnose heart attack, risk stratification, assist in deciding management, assess degree of damage
CK Enzyme; total of three different isoenzymes Heart, brain, and skeletal muscle
Injury to skeletal muscle and/or heart cells
4 to 6 hours after injury, peaks in 18 to 24 hours
48 to 72 hours, unless due to continuing injury
Frequently performed in combination with CK-MB
CK-MB Heart-related isoenzymes of CK Heart primarily, but also in skeletal muscle Injury to heart and/or muscle cells 4 to 6 hours after heart attack, peaks in 12 to 20 hours 24 to 48 hours, unless new or continuing damage Less specific than troponin, may be ordered when troponin is not available
Myoglobin Oxygen-storing protein Heart and other muscle cells Injury to muscle and/or heart cells 2 to 3 hours after injury, peaks in 8 to 12 hours Within one day after injury Used less frequently; sometimes performed with troponin to provide early diagnosis


Biomarker Tests User for Prognosis

These tests may be used to evaluate risk of future cardiac events.
bioMarker what it is
Reason for Increase
When/How Used
hs-CRP Protein Inflammation
May help determine risk of future cardiac events in those patients who have had a heart attack
BNP and NT-proBNP
Heart hormone Heart failure; increased risk of another heart attack Usually used to recognize heart failure, but an increased level in people with ACS indicates an increased risk of recurrent events 

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