Question

An electrocardiogram of a 55 year old patient reflects the patient possibly suffered a myocardial infarction. All of the following are laboratory test you would expect an emergency physician to order except:

-BNP (B-type natriuretic peptide)

-CPK-BB (creatinine phosphokinase-BB)

-troponin

-CPK-MB (creatninine phosphokinase-MB)

Answer 1

Creatinine phosphokinase BB is the answer.

Cardiac troponins T and I are highly sensitive and specific for cardiac damage. Troponin I and T are of equal clinical value.

CK-MB levels increase within 3-12 hours of onset of chest pain, reach peak values within 24 hours, and return to baseline after 48-72 hours.

Studies in several types of ACS have shown that elevated levels of natriuretic peptides - eg, B-type natriuretic peptide (BNP) - are independently associated with adverse outcomes - especially mortality.