gold standard...for mi

The only one that's close to being up-to-date.

Agreed. Go w/Troponin b/c it's most current.

Troponin is both a more sensitive and specific test than CK. Troponin levels stay elevated longer than CK (for about a week) and they don't get elevated unless there has been necrosis of heart muscle tissue. CK on the other hand can get elevated in other disease states (skeletal muscle, myocarditis).

Go with troponin.

Speaking of stuff being current, does anyone know what year the Goljan audio is from?

Troponin

like ypo said troponins become elevated and stay elevated longer than CK-MB and is more specific.

however, according to goljan's audio he says CK-MB is the gold standard b/c it doesn't stay elevated. so you can tell if the pt re-infarcted.

but yea, i'd still go w/ troponins

he is right about that (using ck-mb to tell if there was a 2nd infarct), and it must not be a totally out of date fact/use because it was a question on one of my path exams this year.

stargirl50 said:

he is right about that (using ck-mb to tell if there was a 2nd infarct), and it must not be a totally out of date fact/use because it was a question on one of my path exams this year.

Click to expand...

I had the same question on an exam this year as well.

stargirl50 said:

he is right about that (using ck-mb to tell if there was a 2nd infarct), and it must not be a totally out of date fact/use because it was a question on one of my path exams this year.

Click to expand...

And this is the right way to think about it

If you're asked

"Which lab should be ordered to rule-out MI?"

You should not click "troponin" as a reflex. Step 1 punishes reflexive thinking. The answer may be CK-MB. It could even be myoglobin. The key is understanding the principles behind different tests for MI, and their individual characteristics.

akpete said:

Speaking of stuff being current, does anyone know what year the Goljan audio is from?

Click to expand...

I've heard people say that it is at earliest 2002, because he mentions 9/11 and how New York officials are concerned with asbestosis (since most buildings contain tremendous amounts of asbestos).