Which is the BEST diagnostic enzymatic essay to be done within 4 hours following an acute MI?
CREATINE KINASE: INCREASED IN: Muscle damage (AMI, myocarditis, muscular dystrophy, muscle trauma , aftermath of surgery), brain infarction, defibrillation, cardiac catheterization and surgery, rhabdomyolysis, polymyositis, hypothyroidism. CPK Isoenzymes: Increased CK MB is seen in: (Normal < 6%, hea origin) increased in AMI (begins in 2-12 h, peaks at 12-40 h, returns to normal in 24-72 h); troponin is marker of choice for AMI; pericarditis with myocarditis, rhabdomyolysis, crush injury, Duchenne muscular dystrophy, polymyositis, malignant hypehermia, cardiac surgery. MM: (Normal 94-100%, skeletal muscle origin) increased in crush injury, malignant hypehermia, seizures, IM injections BB: (Normal 0%, brain origin) brain injury (CVA, trauma), metastatic neoplasms (eg, prostate), malignant hypehermia, colonic infarction. Ref: Gomella L.G., Haist S.A. (2007). Chapter 4. Laboratory Diagnosis: Chemistry, Immunology, Serology. In L.G. Gomella, S.A. Haist (Eds),Clinician's Pocket Reference: The Scut Monkey, 11e.
MB isoenzyme of CK
Reagin isoenzyme
LDH4
LDH1