Biomaterial Database

Beyond CK-MB. Biochemical markers for perioperative myocardial infarction. 1994

D T Mangano

Diagnosis of perioperative myocardial infarction remains an important but challenging task. Both clinical symptoms and electrocardiographic changes have inherent limitations. Therefore, biochemical markers for myocardial injury are critical diagnostic tools. The use of creatine kinase isoenzymes (CK-MB) has enhanced detection of perioperative myocardial infarction; however, skeletal muscle damage during surgery limits CK-MB specificity. In this regard, the cardiac troponins appear to offer increased sensitivity, primarily because of their prolonged diagnostic window and even may offer enhanced specificity (especially troponin-I) in patients with surgical skeletal muscle damage. In addition, the convenience of relatively infrequent sampling (because of the prolonged diagnostic window), as well as potential cost savings, make use of the troponin markers attractive. However, definitive data in high-risk patients undergoing either cardiac or noncardiac surgery are still lacking, and significant questions remain regarding appropriate thresholds, specificity of troponin-T, and comparative accuracy of troponin-T, troponin-I, and CK-MB for diagnosis (and prognosis) of perioperative myocardial infarction.

UI	MeSH Term	Description	Entries
D007431	Intraoperative Complications	Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.	Peroperative Complications,Surgical Injuries,Complication, Intraoperative,Complication, Peroperative,Injuries, Surgical,Complications, Intraoperative,Complications, Peroperative,Injury, Surgical,Intraoperative Complication,Peroperative Complication,Surgical Injury
D007527	Isoenzymes	Structurally related forms of an enzyme. Each isoenzyme has the same mechanism and classification, but differs in its chemical, physical, or immunological characteristics.	Alloenzyme,Allozyme,Isoenzyme,Isozyme,Isozymes,Alloenzymes,Allozymes
D009203	Myocardial Infarction	NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).	Cardiovascular Stroke,Heart Attack,Myocardial Infarct,Cardiovascular Strokes,Heart Attacks,Infarct, Myocardial,Infarction, Myocardial,Infarctions, Myocardial,Infarcts, Myocardial,Myocardial Infarctions,Myocardial Infarcts,Stroke, Cardiovascular,Strokes, Cardiovascular
D003402	Creatine Kinase	A transferase that catalyzes formation of PHOSPHOCREATINE from ATP + CREATINE. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic ISOENZYMES have been identified in human tissues: the MM type from SKELETAL MUSCLE, the MB type from myocardial tissue and the BB type from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins.	Creatine Phosphokinase,ADP Phosphocreatine Phosphotransferase,ATP Creatine Phosphotransferase,Macro-Creatine Kinase,Creatine Phosphotransferase, ATP,Kinase, Creatine,Macro Creatine Kinase,Phosphocreatine Phosphotransferase, ADP,Phosphokinase, Creatine,Phosphotransferase, ADP Phosphocreatine,Phosphotransferase, ATP Creatine
D004796	Clinical Enzyme Tests	Analyses for a specific enzyme activity, or of the level of a specific enzyme that is used to assess health and disease risk, for early detection of disease or disease prediction, diagnosis, and change in disease status.	Enzyme Tests, Clinical,Clinical Enzyme Test,Enzyme Test, Clinical,Test, Clinical Enzyme,Tests, Clinical Enzyme
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014336	Troponin	One of the minor protein components of skeletal and cardiac muscles. It functions as the calcium-binding component in a complex with BETA-TROPOMYOSIN; ACTIN; and MYOSIN and confers calcium sensitivity to the cross-linked actin and myosin filaments. Troponin itself is a complex of three regulatory proteins (TROPONIN C; TROPONIN I; and TROPONIN T).	Troponin Complex,Troponins
D015415	Biomarkers	Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, ENVIRONMENTAL EXPOSURE and its effects, disease diagnosis; METABOLIC PROCESSES; SUBSTANCE ABUSE; PREGNANCY; cell line development; EPIDEMIOLOGIC STUDIES; etc.	Biochemical Markers,Biological Markers,Biomarker,Clinical Markers,Immunologic Markers,Laboratory Markers,Markers, Biochemical,Markers, Biological,Markers, Clinical,Markers, Immunologic,Markers, Laboratory,Markers, Serum,Markers, Surrogate,Markers, Viral,Serum Markers,Surrogate Markers,Viral Markers,Biochemical Marker,Biologic Marker,Biologic Markers,Clinical Marker,Immune Marker,Immune Markers,Immunologic Marker,Laboratory Marker,Marker, Biochemical,Marker, Biological,Marker, Clinical,Marker, Immunologic,Marker, Laboratory,Marker, Serum,Marker, Surrogate,Serum Marker,Surrogate End Point,Surrogate End Points,Surrogate Endpoint,Surrogate Endpoints,Surrogate Marker,Viral Marker,Biological Marker,End Point, Surrogate,End Points, Surrogate,Endpoint, Surrogate,Endpoints, Surrogate,Marker, Biologic,Marker, Immune,Marker, Viral,Markers, Biologic,Markers, Immune
D020107	Troponin T	A TROPONIN complex subunit that binds to TROPOMYOSIN. There are three troponin T subtypes: troponin T1, T2 and T3. Troponin T2 is cardiac-specific whereas troponin T2 and T3 are skeletal subtypes. Troponin T2 is a BIOMARKER for damaged or injured CARDIAC MYOCYTES and mutations in troponin T2 gene are associated with FAMILIAL HYPERTROPHIC CARDIOMYOPATHY.	Troponin T1,Troponin T2,Troponin T3,Troponin-T