The cardiac enzyme panel is used when an acute myocardial infarction or heart attack is suspected.  Most institutions test for the following:

• Total Creatine Kinase (CK)
• Creatine Kinase (MB)
• LDH
• Troponin

Additional tests

• Albumin, Ischemia-Modified
• C reactive protein
• B-Natriuretic peptide

OUTLINE

Reference Methods
Clinical Utility
Interfering Diseases or Substances that Alter Levels
Commonly Used Terms
Internet Links

INTERFERENCES	CHARACTERIZATION
MARATHON RUNNING
Effect of Marathon Running on Hematologic and Biochemical Laboratory Parameters, Including Cardiac Markers Alexander Kratz, MD, PhD, MPH Kent B. Lewandrowski, MD Arthur J. Siegel, MD Kelly Y. Chun, PhD James G. Flood, PhD Elizabeth M. Van Cott, MD and Elizabeth Lee-Lewandrowski, PhD, MPH	Am J Clin Pathol 2002;118:856-863 Abstract quote Participants in marathon races may require medical attention and the performance of laboratory assays. We report the changes in basic biochemical parameters, cardiac markers, CBC counts, and WBC differentials observed in participants in a marathon before, within 4 hours, and 24 hours after a race. The concentrations of glucose, total protein, albumin, uric acid, calcium, phosphorus, serum urea nitrogen, creatinine, bilirubin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, total creatine kinase, creatine kinase-MB, myoglobin, and the anion gap were increased after the race, consistent with the effects of exertional rhabdomyolysis and hemolysis. The increase in WBC counts was due mainly to neutrophilia and monocytosis, with a relative decrease in circulating lymphocytes, consistent with an inflammatory reaction to tissue injury. A significant percentage of laboratory results were outside the standard reference ranges, indicating that modified reference ranges derived from marathon runners might be more appropriate for this population. We provide a table of modified reference ranges (or expected ranges) for basic biochemical, cardiac, and hematologic laboratory parameters for marathon runners.

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