Laboratory
infarction diagnostics are based on the detection of elevated serum activities of total
Creatine Kinase (CK),
Creatine Kinase isoensyme MB, (CKMB),
Lactate dehydrogenase (LDH),
isoenzyme forms of LDH and
transaminases. Determination of these cardiac marker
enzymes permits a highly sensitive diagnosis of transmural
myocardial infarction. In such patients the diagnosis of acute
myocardial infarction can be confirmed by the clinical, symptoms, and changes in the ECG in addition to the
enzyme assays. The 50 AMI patients selected in the present study were those admitted to the ICCU of Shri Krishna Hospital, Karamsad. The blood samples were taken at the time of admission (ie. within four hours of the start of
chest pain). The samples were analyzed for CK, CKMB,
SGOT, (Serum
glutamate oxaloactate
transaminase) αHBDH α-
hydroxybutyrate dehydrogenase and
troponin T. The serum CKMB activity in AMI showed an increase only 5-6 hours after the commencement of
chest pain. The elevation in
SGOT and αHBDH was still delayed. At the same time we could observe that the cardiac
Troponin T (cTnT) was elevated at the time of admission of the patient itself. This increase of cTnT in AMI patients was 20 times higher than the normal blood donors. The controls included 25 normal blood donors and 25 patients with polytraumatic
injuries with no chest
contusion. The study shows that cTnT estimation could serve in the early diagnosis of AMI. The increase of cardiac
troponin T in AMI patients was 20 times higher than the normal blood donors in AMI patients at the time of admission. Cardiac
troponin T in serum appears to be a more sensitive
indicator of myocardial cell injury than CKMB activity and its detection in the circulation may be a useful prognostic
indicator in patients with
unstable angina as well. When the blood of normal blood donors or that of patients with polytraumatic injury was analysed the
troponin T values were well within the normal range in both the above categories showing that cardiac
troponin T is highly specific for heart tissue. Although CKMB and cardiac
troponin T are released soon after the myocardial injury, the release of cardiac
troponin T is much earlier than CKMB thereby invalidating the important role of cardiac
troponin T in diagnosing AMI. Cardiac
troponin T has been shown to be highly sensitive for cardiac injury and not elevated in any other
trauma, heavy exercise or skeletal muscle injury. Cardiac
troponin T is ordinarily undetectable in healthy individuals, and so its measurement can serve as a powerful tool in the diagnosis of AMI.