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Common Congenital Heart Lesions - page 44 / 126

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Serum Biomarker Time Course

Figure “borrowed” from Dr. Hammett-Staber’s lecture…Refer to that for extra info!

TnI

TnT

CK-MB

myo

reference range

  • 0

    1

2

3 Time (days)

4

5

10

Reference ranges and time courses: Myoglobin (myo): males, 28-72 ng/mL; females, 25-58 ng/mL. Time to increase 2-4 h; time to peak 5-12 h; return to normal 1-2 days

Troponin T (cTnT): <0.03 ng/mL Time to increase 3-6 h; time to peak 12-28 h; return to normal 5-15 d

Troponin I (cTnI): <0.1 ng/mL. Time to increase 3-6 h; time to peak 12-24 h; return to normal 5-7 d

CK (total): males, 70-185 U/L; females, 45-145 U/L. Time to increase 3-8 h; time to peak 12-36 h; return to normal 1-4 d.

CK-MB: <6 ng/mL. Time to increase 3-12 h; time to peak 12-24 h; return to normal 1-2 d.

Important points:

  • 1.

    The rise in myoglobin occurs first.

  • 2.

    Increases in CK-MB and Tn (either I or T) begins at about the same time for most

patients.

  • 3.

    Normally, troponin is not detectable in serum from cardiac healthy patients.

  • 4.

    TnI and TnT remain elevated for several days to ~2 weeks after an MI. (The biphasic pattern for TnT is thought to reflect the initial release of either a cytosolic or “soluble” fraction followed by the release of the structurally bound fraction.) Should there be a second MI, the levels increase further.

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