Myocardial infarction (MI) Cardiac markers related to MI Detection methods

1. Cardiac Markers
Prepared by:
Michael Mullokandov
2011

2. • Myocardial infarction (MI)
• Cardiac markers related to MI
• Detection methods
Outline
2

3. Myocardial infarction
• Acute myocardial infarction
is the rapid development of
myocardial necrosis caused
by a critical imbalance
between the oxygen supply
and demand of the
myocardium.
3

4. Myocardial infarction
4Jonathan Leor

5. Cardiac markers
• Troponin
• Creatine kinase-MB
• Myoglobin
• Lactate dehydrogenase
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•B-type natriuretic peptide (BNP)
•C-reactive protein (CRP)
•Myeloperoxidase (MPO)
•Ischemia modified albumin (IMA)
http://emedicine.medscape.com/article/811905-overview

6. Troponin
• Composed of 3 proteins- troponin C, cardiac troponin
I and cardiac troponin T.
• Troponin I especially has a high affinity for
myocardial injury
• Rises within 3 hours and persists for up to 7 days
• Normal values are low, with troponin I being lower
than 0.6 ng/ml and troponin T normally ranging from
0 to 0.2 ng/ml
• Any rise can indicate myocardial cell damage
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7. 7
Troponin

8. 9
Creatine kinase-MB

9. 10
Myoglobin
• An oxygen- binding
protein found in cardiac
and skeletal muscle
• Level rises within 1 hour
after cell death, peaks
in 4 to 6 hours
• Returns to normal
within 24 to 36 hours
John Kendrew 1962 Nobel Prize in chemistry

10. • Elevations in LDH levels accur 24 hours
following MI and peak 48 to 72 hours
• Normally LDH 1 is lower than LDH 2
• Normal value of LDH in conventional is 140 to
280 international units/L
Lactate dehydrogenase
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Lactate dehydrogenase

12. Determining CK-MB (mass) / CK
(activity)
• Total CK activity is determined by a simple enzyme
assay (phosphocreatine + ADP  ATP)
• CK-MB mass is determined by a two-antibody
“sandwich” assay.
YYYYY
YYYYY
anti-CK-B coated tube
YYYYY
YYYYY
Tagged anti-CK-M
YYYYY
YYYYY
POSITIVE
Y
Y Y
Y
YYYYY
YYYYY
Substrate
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13. Future detection methods
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Electrochemical immunosensor for simultaneous detection of dual cardiac
markers based on a poly(dimethylsiloxane)-gold nanoparticles composite
microfluidic chip: a proof of principle.
Clin Chem. 2010; 56(11):1701-7 (ISSN: 1530-8561)
Ling Y, Pong T, Vassiliou C, et al. Implantable magnetic relaxation sensors
measure cumulative exposure to cardiac biomarkers. Nature Biotech 2011.
DOI:10.1038/nbt.1780. Available at:
http://www.nature.com/naturebiotechnology.

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