Miner C, Cahill S and Hamburg RJ
We propose a contemporary and novel algorithm using cardiac specific biomarkers for patients presenting with chest pain and other disease states associated with elevated levels of troponin T (TnT) and/or creatine kinase (CK) isoforms. We predict the implementation of this novel algorithm will differentiate between a type-I and type-II myocardial infarction (MI). We summarize advances using high-sensitivity Tn assays (hs-Tn), which include a greater sensitivity for rapid diagnosis of MI within 1-3 hours of symptom onset and is predictive of patient prognosis. We summarize the use of CK isoenzymes as a diagnostic marker for various disease states, determine myocardial infarct size, differentiate MI type, and diagnose myocardial reinfarction. We propose further studies using CK isoforms to define transient ischemic attack (TIA) and cerebrovascular accident (CVA) in order to direct treatments for acute CVA.