Other Biochemical Tests

Myoglobin, an early marker of AMI (84-85), and the cardiac troponins T and I, which are medium and late markers (86-88) specific for myocyte damage, hold promise to improve the identification of patients with AMI and minor myocardial injury. The Systematic Review examined myoglobin in its assessment of biomarkers in ACI (6). The reviewers found that in five studies of 831 ED patients, serial myoglobin had a sensitivity of 90% (95% CI: 78-96%) and a specificity of 92% (95% CI: 82-97%) (6). In 10 studies of 1395 ED patients, a single presentation myoglobin had a sensitivity of only 49% (95% CI: 41-57%) (6). As was found in studies of serial vs single (presentation) values of CK-MB, myoglobin, although an early marker, cannot be used as a one-time

Table 10 CK

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