Cardiac marker - wikipedia Cardiac marker Cardiac marker Medical diagnostics LOINC 58260 - 1 ( edit on Wikidata ) Cardiac markers are biomarkers measured to evaluate heart function. They are often discussed in the context of myocardial infarction, but other conditions can lead to an elevation in cardiac marker level. Most of the early markers identified were enzymes, and as a result, the term `` cardiac enzymes '' is sometimes used. However, not all of the markers currently used are enzymes. For example, in formal usage, troponin would not be listed as a cardiac enzyme. Contents 1 Applications of measurement 2 Types 2.1 suPAR 3 Limitations 4 See also 5 References 6 Further reading 7 External links Applications of measurement Measuring cardiac biomarkers can be a step toward making a diagnosis for a condition. Whereas cardiac imaging often confirms a diagnosis, simpler and less expensive cardiac biomarker measurements can advise a physician whether more complicated or invasive procedures are warranted. In many cases medical societies advise doctors to make biomarker measurements an initial testing strategy especially for patients at low risk of cardiac death. Many acute cardiac marker IVD products are targeted at nontraditional markets, e.g., the hospital ER instead of traditional hospital or clinical laboratory environments. Competition in the development of cardiac marker diagnostic products and their expansion into new markets is intense. Recently, the intentional destruction of myocardium by alcohol septal ablation has led to the identification of additional potential markers. Types Types of cardiac markers include the following : Test Sensitivity and specificity Approximate peak Description Troponin test The most sensitive and specific test for myocardial damage. Because it has increased specificity compared with CK - MB, troponin is a superior marker for myocardial injury. 12 hours Troponin is released during MI from the cytosolic pool of the myocytes. Its subsequent release is prolonged with degradation of actin and myosin filaments. Isoforms of the protein, T and I, are specific to myocardium. Differential diagnosis of troponin elevation includes acute infarction, severe pulmonary embolism causing acute right heart overload, heart failure, myocarditis. Troponins can also calculate infarct size but the peak must be measured in the 3rd day. After myocyte injury, troponin is released in 2 -- 4 hours and persists for up to 7 days. Creatine Kinase ( CK - MB ) test It is relatively specific when skeletal muscle damage is not present. 10 -- 24 hours The CK - MB isoform of creatine kinase is expressed in heart muscle. It resides in the cytosol and facilitates movement of high energy phosphates into and out of mitochondria. Since it has a short duration, it can not be used for late diagnosis of acute MI but can be used to suggest infarct extension if levels rise again. This is usually back to normal within 2 -- 3 days. Lactate dehydrogenase ( LDH ) LDH is not as specific as troponin. 72 hours Lactate dehydrogenase catalyses the conversion of pyruvate to lactate. LDH - 1 isozyme is normally found in the heart muscle and LDH - 2 is found predominantly in blood serum. A high LDH - 1 level to LDH - 2 suggest MI. LDH levels are also high in tissue breakdown or hemolysis. It can mean cancer, meningitis, encephalitis, or HIV. This is usually back to normal 10 -- 14 days. Aspartate transaminase ( AST ) This was the first used. It is not specific for heart damage, and it is also one of the liver function tests. Myoglobin ( Mb ) low specificity for myocardial infarction 2 hours Myoglobin is used less than the other markers. Myoglobin is the primary oxygen - carrying pigment of muscle tissue. It is high when muscle tissue is damaged but it lacks specificity. It has the advantage of responding very rapidly, rising and falling earlier than CK - MB or troponin. It also has been used in assessing reperfusion after thrombolysis. Ischemia - modified albumin ( IMA ) low specificity IMA can be detected via the albumin cobalt binding ( ACB ) test, a limited available FDA approved assay. Myocardial ischemia alters the N - terminus of albumin reducing the ability of cobalt to bind to albumin. IMA measures ischemia in the blood vessels and thus returns results in minutes rather than traditional markers of necrosis that take hours. ACB test has low specificity therefore generating high number of false positives and must be used in conjunction with typical acute approaches such as ECG and physical exam. Additional studies are required. Pro-brain natriuretic peptide This is increased in patients with heart failure. It has been approved as a marker for acute congestive heart failure. Pt with < 80 have a much higher rate of symptom - free survival within a year. Generally, pt with CHF will have > 100. Glycogen phosphorylase isoenzyme BB 0.854 and 0.767 7 hours Glycogen phosphorylase isoenzyme BB ( abbreviation : GPBB ) is one of the three isoforms of glycogen phosphorylase. This isoform of the enzyme exists in cardiac ( heart ) and brain tissue. Because of the blood -- brain barrier, GP - BB can be seen as being specific to heart muscle. GP - BB is one of the `` new cardiac markers '' which are considered to improve early diagnosis in acute coronary syndrome. During the process of ischemia, GP - BB is converted into a soluble form and is released into the blood. A rapid rise in blood levels can be seen in myocardial infarction and unstable angina. GP - BB is elevated 1 -- 3 hours after process of ischemia. SuPAR suPAR, soluble urokinase - type plasminogen activator receptor, ( NCBI Accession no. AAK31795 ) is the soluble form of uPAR. uPAR is a membrane bound receptor for uPA, otherwise known as urokinase. suPAR results from the cleavage and release of membrane - bound uPAR. suPAR concentration positively correlates to the activation level of the immune system and is present in plasma, urine, blood, serum, and cerebrospinal fluid. suPAR is a biomarker for activation of the inflammatory and immune systems. suPAR levels are positively correlated with pro-inflammatory biomarkers, such as tumor necrosis factor - α, leukocyte counts, and C - reactive protein. Elevated levels of suPAR are associated with increased risk of systemic inflammatory response syndrome ( SIRS ), cancer, Focal segmental glomerulosclerosis, cardiovascular disease, type 2 diabetes, infectious diseases, HIV, and mortality. suPARnostic is a prognostic test used to detect suPAR levels in blood plasma. Limitations Reference ranges for blood tests, measured in units, including several cardiac markers. Depending on the marker, it can take between 2 and 24 hours for the level to increase in the blood. Additionally, determining the levels of cardiac markers in the laboratory - like many other lab measurements - takes substantial time. Cardiac markers are therefore not useful in diagnosing a myocardial infarction in the acute phase. The clinical presentation and results from an ECG are more appropriate in the acute situation. However, in 2010, research at the Baylor College of Medicine revealed that, using diagnostic nanochips and a swab of the cheek, cardiac biomarker readings from saliva can, with the ECG readings, determine within minutes whether someone is likely to have had a heart attack. Comparison of cardiac markers over time Comparison of cardiac marker in the first hours after chestpain onset and the relative concentration. Comparison of cardiac marker in the first hours after chestpain onset and the multiples of the cutoff. Kinetics of cardiac markers in myocardial infarction with or without reperfusion treatment. See also Myocardial markers in myocardial infarction Reference ranges for blood tests # Cardiac tests References Jump up ^ Rao SP, Miller S, Rosenbaum R, Lakier JB ( August 1999 ). `` Cardiac troponin I and cardiac enzymes after electrophysiologic studies, ablations, and defibrillator implantations ''. Am. J. Cardiol. 84 ( 4 ) : 470, A9. doi : 10.1016 / S0002 - 9149 ( 99 ) 00337 - 9. PMID 10468091. Jump up ^ American Society of Nuclear Cardiology, `` Five Things Physicians and Patients Should Question '' ( PDF ), Choosing Wisely : an initiative of the ABIM Foundation, American Society of Nuclear Cardiology, retrieved August 17, 2012 Jump up ^ Hendel, R.C. ; Berman, D.S. ; Di Carli, M.F. ; Heidenreich, P.A. ; Henkin, R.E. ; Pellikka, P.A. ; Pohost, G.M. ; Williams, K.A. ; American College of Cardiology Foundation Appropriate Use Criteria Task Force ; American Society of Nuclear Cardiology ; American College Of, R. ; American Heart, A. ; American Society of Echocardiology ; Society of Cardiovascular Computed Tomography ; Society for Cardiovascular Magnetic Resonance ; Society Of Nuclear, M. ( 2009 ). `` ACCF / ASNC / ACR / AHA / ASE / SCCT / SCMR / SNM 2009 Appropriate Use Criteria for Cardiac Radionuclide Imaging ''. Journal of the American College of Cardiology. 53 ( 23 ) : 2201 -- 2229. doi : 10.1016 / j. jacc. 2009.02. 013. PMID 19497454. Jump up ^ `` Cardiac Marker Diagnostic Testing Markets ''. TriMark Publications, LLC. November 2011. Jump up ^ Lewis GD ; Wei R ; Liu E ; et al. ( October 2008 ). `` Metabolite profiling of blood from individuals undergoing planned myocardial infarction reveals early markers of myocardial injury ''. J. Clin. Invest. 118 ( 10 ) : 3503 -- 12. doi : 10.1172 / JCI35111. PMC 2525696. PMID 18769631. Jump up ^ NISSEN NI, RANLOV P, WEIS - FOGH J ( July 1965 ). `` EVALUATION OF FOUR DIFFERENT SERUM ENZYMES IN THE DIAGNOSIS OF ACUTE MYOCARDIAL INFARCTION ''. Br Heart J. 27 ( 4 ) : 520 -- 6. doi : 10.1136 / hrt. 27.4. 520. PMC 503341. PMID 14324110. Jump up ^ `` Use of Cardiac Markers in the Emergency Department : - eMedicine ''. Retrieved 2009 - 01 - 06. Jump up ^ Christenson RH ; Ohman EM ; Topol EJ ; et al. ( September 1997 ). `` Assessment of coronary reperfusion after thrombolysis with a model combining myoglobin, creatine kinase - MB, and clinical variables. TAMI - 7 Study Group. Thrombolysis and Angioplasty in Myocardial Infarction - 7 ''. Circulation. 96 ( 6 ) : 1776 -- 82. doi : 10.1161 / 01. cir. 96.6. 1776. PMID 9323061. Jump up ^ Lippi, G. ; Mattiuzzi, C. ; Comelli, I. ; Cervellin, G. ( 2013 ). `` Glycogen phosphorylase isoenzyme BB in the diagnosis of acute myocardial infarction : a meta - analysis ''. Biochem Med ( Zagreb ). 23 ( 1 ) : 78 -- 82. doi : 10.11613 / bm. 2013.010. PMC 3900091. PMID 23457768. Further reading Ross G, Bever F, Uddin Z, Devireddy L, Gardin J ( 2004 ). `` Common scenarios to clarify the interpretation of cardiac markers ''. J Am Osteopath Assoc. 104 ( 4 ) : 165 -- 76. PMID 15127984. Full text on GPBB External links Quick overview, with graph eMedicine -- more detailed Abnormal clinical and laboratory findings for blood tests ( R70 -- R79, 790 ) Red blood cells Size Anisocytosis Macrocyte Microcyte Shape Poikilocytosis membrane abnormalities : Acanthocyte Codocyte Ovalocyte Spherocyte Dacrocyte Echinocyte Schistocyte Degmacyte Drepanocyte Stomatocyte Knizocyte Hemoglobinization Anisochromia Hypochromia Inclusion bodies Developmental Howell -- Jolly body Basophilic stippling Pappenheimer bodies Cabot rings Hemoglobin precipitation Heinz body Other Rouleaux Reticulocyte Elevated ESR Lymphocytes Smudge cell Downey cell Small molecules Blood sugar Hypoglycemia Hyperglycemia Prediabetes Impaired fasting glucose Impaired glucose tolerance Oxyhyperglycemia Nitrogenous Azotemia Hyperuricemia Hypouricemia Proteins LFT Elevated transaminases Elevated ALP Hypoproteinemia Hypoalbuminemia Other Elevated cardiac markers Elevated alpha - fetoprotein Minerals Iron overload disorder Pathogens / sepsis Bacteremia Viremia Fungemia Parasitemia Algaemia Common for blood tests ( CPT 82000 -- 84999 ) Electrolytes Sodium Potassium Chloride Calcium Renal function Creatinine Urea BUN - to - creatinine ratio Plasma osmolality Serum osmolal gap Acid - base Anion gap Arterial blood gas Base excess Bicarbonate CO content Iron tests Ferritin Serum iron Transferrin saturation Total iron - binding capacity Transferrin Transferrin receptor Hormones ACTH stimulation test Thyroid function tests Thyroid - stimulating hormone Metabolism Blood lipids Cardiovascular Cardiac marker Troponin test CPK - MB test Lactate dehydrogenase Myoglobin Glycogen phosphorylase isoenzyme BB Liver function tests Proteins Human serum albumin Serum total protein ALP transaminases ALT AST AST / ALT ratio Bilirubin Unconjugated Conjugated Pancreas Amylase Lipase Pancreatic lipase Retrieved from `` https://en.wikipedia.org/w/index.php?title=Cardiac_marker&oldid=793482661 '' Categories : Biomarkers Cardiology Chemical pathology Hidden categories : All articles with unsourced statements Articles with unsourced statements from April 2017 Talk Contents About Wikipedia Nederlands Tiếng Việt Edit links This page was last edited on 2 August 2017, at 01 : 11. About Wikipedia

Question: what are the different cardiac biomarkers in heart disease
Answer: Troponin