Topic overview

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Cardiac troponins are highly specific markers of myocardial injury. They typically rise within hours, peak during the first day, and may remain elevated for days; high-sensitivity assays and serial measurements support interpretation against the 99th-percentile reference limit. A rise or fall helps distinguish acute injury from chronic elevation, though an elevated troponin does not by itself establish AMI. CK-MB is less specific because it is also present in skeletal muscle, but its shorter period of elevation can be useful when assessing possible reinfarction. The lesson compares these markers’ kinetics, interpretation, and analytical considerations, including sample handling and sources of misleading CK-MB results. It also outlines why troponin is generally preferred and when CK-MB may still have a role.