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Medicine General 1927ee0d

Which of the following is the preferred marker for detecting Acute STEM I in Atheletes:

A
CK-MB
B
Troponin T/I
C
C-Reactive Protein
D
LDH
High-Yield Explanation
Answer is B (Troponin T/I) Cardiac specific Troponins (Troponin T and Troponin I) are the biochemical markers of choice for detection of Acute MI in both healthy individuals as well as atheletes. 'The measurement of cTnT and cTnl (cardiac specific Troponin T & I) is of considerable diagnostic usefulness and they are now the preferred biochemical markers for MI' CK-MB isoenzvme is not a sensitive marker for AM I in Athletes The MB isoenzyme of CK has the advantage over total CK that it is not present in significant concentration in extracardiac tissue and therefore is considerably more specific. CK-MB rises within 4-8 hr after Acute MI and elevated CK-MB is accepted as a sensitive marker for diagnosis of Acute Myocardial Infarction in healthy individuals. Individuals who train for long distance races (Athletes like marathan runners) however have been observed to have very high resting concentration of CK-MB in skeletal muscles. This may be owing to an adaptation by the athelete to produce a higher relative content of CKMB within skeletal muscles themselves. Studies of CK-MB levels in trained marathan runners have reveaked that total CK and percentage of MB isoenzyme is asymptomatic runners have been comparable to levels of CK and CKMB in patients with myocardial Infarction. Because of nonspecificity of CKMB fraction in runners (atheles) the measurement of this isoenzyme is of little value in making an early diagnosis of myocardial injury in athelets. A measurement of troponin I is much better because it is specific for cardiac injury'

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