Clinical value of biochemical markers in the diagnosis of acute myocardial infarction.

Current strategy for the use of biochemical markers in the diagnosis of acute myocardial infarction is not yet uniform. New markers of myocardial damage have significantly altered the former viewpoints. The study included 41 patients with confirmed acute myocardial infarction (25 males and 16 females, age range 42-85 years). Control group comprised of 25 patients with chronic renal failure without signs of acute coronary event (n = 11) and patients with confirmed coronary artery disease (n = 14). The level and activity of CKMB (microgram/L and U/L), and the level of myoglobin and cTnl were determined. The results showed the sensitivity of CKMB (microgram/L) in the first six hours from the onset of pain to be statistically significantly higher than the sensitivity of cTnl, while myoglobin was confirmed to be the earliest marker. Determination of CKMB (U/L) activity should be abandoned since it was found to have the lowest sensitivity and specificity. Also, a combination of myoglobin and CKMB (microgram/L) showed a statistically significantly higher sensitivity and diagnostic efficacy but lower diagnostic specificity compared to the combination of myoglobin and cTnl.