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Peak CKMB and cTnT accurately estimates myocardial infarct size after reperfusion

Erik Hedström1, Karin Aström-Olsson, Hans Ohlin

  • 1Department of Clinical Physiology, Lund University, Lund, Sweden.

Scandinavian Cardiovascular Journal : SCJ
|March 17, 2007
PubMed

Insights

Peak creatine kinase MB (CKMB) and cardiac troponin T (cTnT) levels after reperfusion therapy can estimate myocardial infarct size. Optimal sampling times for CKMB and cTnT are 3, 6, and 12 hours post-PCI.

Area of Science:

  • Cardiology
  • Biomarker Research
  • Medical Imaging

Background:

  • Acute myocardial infarction requires timely reperfusion therapy.
  • Accurate assessment of myocardial infarct size (IS) is crucial for patient management.
  • Biomarkers like CKMB and cTnT are used to evaluate cardiac injury.

Purpose of the Study:

  • Determine time-to-peak for CKMB and cTnT post-reperfusion.
  • Compare peak and cumulative biomarker values for IS estimation.
  • Evaluate the utility of routine clinical sampling for IS assessment.

Main Methods:

  • 38 patients with first-time myocardial infarction underwent primary PCI.
  • Biomarkers (CKMB, cTnT) measured at multiple time points post-PCI in 21 patients.
  • Delayed contrast-enhanced MRI (DE-MRI) used for IS assessment.

Main Results:

  • Time-to-peak for CKMB and cTnT observed around 7.6-8.1 hours.
  • Peak and cumulative biomarker values strongly correlated with DE-MRI IS estimates (r(s)=0.8-0.98).
  • Clinical routine sampling showed weaker correlations (r(s)=0.47-0.60).

Conclusions:

  • Peak CKMB and cTnT levels are likely captured with sampling at 3, 6, and 12 hours post-PCI.
  • These peak biomarker values effectively estimate myocardial infarct size.
  • Routine clinical sampling may be less reliable for IS estimation compared to optimized timing.
Abstract

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