Trop v CK

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bannie22

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Which one does your institution use to test and trend for angina?nstemi v stemi?
and why?
thanks!

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Which one does your institution use to test and trend for angina?nstemi v stemi?
and why?
thanks!
Trop is a hell of a lot more sensitive, and rises faster besides. I don't know of anywhere that still preferentially tests CKs to evaluate for an MI. I mean, once you know they have a heart attack, I suppose the CK elevation can give you a bit of information about timing/prognosis, but nothing that would effect management.

And STEMI isn't a diagnosis made by enzymes.
 
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I don't know why, but for some reason, when I saw the title of this thread, I was expecting a cardiologist or cardio fellow posting in order to start stir about I don't know.. 'mind blowing new evidence' coming out on 'troponins v.s. ck' that's going to potentially flip current clinical practice on it's head..

or something along those lines. and I went whoo, maybe I'll start some water cooler talk at work..
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Troponins are gold standard. for reasons Raryn said.
(Last time I remember ordering a CK was for Rhabdo...but that's entirely besides the point)
STEMIs (ST elevation myocardial infarction) refer to ST elevation on the ECG..
(v.s. an NSTEMI or non-STEMI). mildly confused about why the questions are being asked..
 
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I will use a ck-mb at 2-5 days post infarct if I'm worried about ongoing ischemia because the mb should have normalized by then while the troponin can still be lingering
 
I will use a ck-mb at 2-5 days post infarct if I'm worried about ongoing ischemia because the mb should have normalized by then while the troponin can still be lingering

Many labs are now no longer offering CK-MB.
 
The only time I used CK during residency or even Cards fellowship was for rhabdo.

I'll echo what was said above, STEMI is obviously not diagnosed with a lab test, and for UA/NSTEMI or "re-infarction" our decision to take to the lab is really more based on the clinical picture/EKGs than just a lab test.
 
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