The aim of the present study was to assess the clinical values of serum total
Creatine Kinase (Total-CK), Creatine Kinase-MB isoenzyme (CK-MB) and total
Lactate Dehydrogenase (LDH) compared with cardiac Troponin-I (cTnI) in the
diagnosis of acute coronary syndromes (ACS). The study was carried on 27 patients
with acute coronary syndromes from the intensive care unit (ICU) of the Egyptian
National Heart Institute (NHI), Imbaba, Giza, Egypt, in addition to 9 healthy age
matched subjects served as controls. Patients were classified into 3 groups: Unstable
angina group, acute myocardial infarction group with ST-segment elevation and
myocardial infarction group with non ST-segment elevation. Blood samples have
been taken from the patients on admission to NHI (ICU) and at 24 and 48 hours after
their admission. Serum Total-CK, CK-MB, LDH were determined
spectrophotometrically and cTnI was determined using Enzyme Linked
Immunosorbent Assay (ELISA). The obtained results revealed that there was a
positive significant correlation between cTnI and the other biochemical markers
except with LDH on admission to NHI (ICU). Percent sensitivity was also determined.
On admission both cTnI and CK-MB showed the highest sensitivity (59 %) while after
24 hours of admission, cTnI showed the highest sensitivity (85 %) and after 48 hours
of admission LDH showed the highest sensitivity (77 %). Specificity level 100%.
In conclusion, the present study showed that cTnI was the most sensitive
biochemical marker than the other traditional biochemical markers (Total-CK, CKMB,
and LDH) for establishing the diagnosis of ACS during the first 48 hours after
admission to the hospital. It is better, however to use a combination of more than one
marker in the diagnosis of Acute Coronary Syndrome.