CKMB and Troponin

[Halaljello]

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I hate it when 2 sources of info conflict. I'm looking in FA and it says CK MB is the test of choice first 24 hrs post MI and it (along with troponin) are elevated the first four hours or so....

now i get a question in Qbank saying some guy's having chest pain radiating to his left arm for the first 4 hours...what test should i order?
duh...CKMB right? nope! its Troponin!! wtf!!!??!? anyone know the truth about troponin/ckmb and when to use it cuz this is a high yield concept i dont want to fudge up in the next few days i take boards.

😡 😡

thanks

 

[Idiopathic]

As far as boards go, troponin shows up earlier and stays longer. If I have to choose, I go with troponins 100% of the time, just because that seems to be the standard of care these days, as far as the USMLE is concerned.

 

[mikecwru]

Don't get too stressed, I've seen cardiologists mess this up. Troponin elevates within the first several hours and lasts for days. CK-MB elevates quicker and lasts a lot less. When we check "cardiac markers" most centers check CK-MB and Troponin and check at least two sets several hours apart because of these curves. I'm wondering if the question is giving you just when Troponin *should* be elevated. If that's the case, maybe they're commenting on the fact that Troponin is more SPECIFIC than CK-MB.

mike

 

[Idiopathic]

Troponins are definitely more specific than CK-MB and LDH. I just stick with the assumption that if cardiac pathology is present, they want troponins to be the answer. Best for determining early infarcts, reinfarcts and late infarcts (i.e. 10 days out), which really is CK-MB's biggest problem, that it cant diagnose an MI more than 3-4 days out.

 

[buddindoc]

before doing anything get an ekg...then troponin

 

[realruby2000]

if thats the case, then why does first aid say CKMB is the test of choice the first 24hrs? shouldnt it be troponin cuz its more specific?

 

[StringBean]

Just wanted to bump this back up to the top cuz I'm wondering the same... why is CK-MB the test of choice in the 1st 24 hrs & not troponin? (according to FA)