Cardiac Myoglobin/CK-MB/Troponin I Combo Rapid Detection Kit
The Myoglobin/CK-MB/Troponin I Combo Test is a rapid chromatographic immunoassay for the qualitative detection of human Myoglobin, CK-MB and cardiac Troponin I in whole blood, serum or plasma as an aid in the diagnosis of myocardial infarction (MI).
Myoglobin (MYO), Creatine Kinase MB (CK-MB) and cardiac Troponin I (cTnI) are proteins released into the bloodstream after cardiac injury. Myoglobin is a heme-protein normally found in skeletal and cardiac muscle with a molecular weight of 17.8 kDa. It constitutes about 2 percent of total muscle protein and is responsible for transporting oxygen within muscle cells. When muscle cells are damaged, Myoglobin is released into the blood rapidly due to its relatively small size. The level of Myoglobin increases measurably above baseline within 2 - 4 hours post-infarct, peaking at 9 - 12 hours, and returning to baseline within 24 - 36 hours.
CK-MB is an enzyme also present in the cardiac muscle, with a molecular weight of 87.0 kDa. Creatine Kinase is a dimeric molecule formed from two subunits designated as “M” and “B”, which combine to form three different isoenzymes, CK-MM, CK-BB and CK-MB. CK-MB is the isoenzyme of Creatine Kinase most involved in the metabolism of cardiac muscle tissue. The release of CK-MB into the blood following an MI can be detected within 3 - 8 hours after the onset of symptoms. It peaks within 9 to 30 hours, and returns to baseline levels within 48 to 72 hours.
Cardiac Troponin I is a protein found in cardiac muscle, with a molecular weight of 22.5 kDa. Troponin I is part of a three subunit complex comprised of Troponin T and Troponin C. Along with tropomyosin, this structural complex forms the main component that regulates the calcium sensitive ATPase activity of actomyosin in striated skeletal and cardiac muscle. After cardiac injury occurs, Troponin I is released into the blood 4 - 6 hours after the onset of pain. The release pattern of Troponin I is similar to CK-MB, but while CK-MB levels return to normal after 72 hours, Troponin I remains elevated for 6 - 10 days, thus providing for a longer window of detection for cardiac injury.
1. Wong SS. Strategic utilization of cardiac markers for diagnosis of acute myocardial infarction. Ann Clin Lab Sci, 26:301-12, 1996.
2. Kagen LJ. Myoglobin methods and diagnostic uses. CRC Crit. Rev. Clin. Lab. Sci., 2:273, 1978.
3. Chapelle JP. et al. Serum myoglobin determinations in the assessment of acute myocardial infarction. Eur. Heart Journal, 3:122, 1982.
4. Apple FS, Preese LM. Creatine kinase-MB: detection of myocardial infarction and monitoring reperfusion. J Clin Immunoassay, 17:24-9, 1994.
5. Lee TH, Goldman L. Serum enzyme assays in the diagnosis of acute myocardial infarction. Ann Intern Med, 105:221-233, 1986.
6. Kallner A, Sylven C, Brodin. U, et al. Early diagnosis of acute myocardial infarction; a comparison between chemical predictors. Scand J Clin Lab Invest, 49:633-9, 1989.
7. Adams, et al. Biochemical markers of myocardial injury, Immunoassay Circulation 88: 750-763, 1993.
8. Mehegan JP, Tobacman LS. Cooperative interaction between troponin molecules bound to the cardiac thin filament. J.Biol.Chem. 266:966, 1991.