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This is a brief summary of lab value interpretation and is not intended in any way to be comprehensive or replace any conversation of your results with your doctor.

CARDIAC LAB VALUES

Creatine Kinase aka Creatine Phosphokinase (CK) - Levels rise 4 to 8 hours after an acute MI (Myocardial Infarction), peaking at 16 to 30 hours and returning to baseline within 4 days. Creatine Kinase is muscle enzyme found in the heart and muscles. Increased CK-MB is seen with heart muscle damage. Increased CK-MM is seen with skeletal muscle injury. Strenuous exercise, weight lifting, surgical procedures, high doses of aspirin and other medications can elevate CK. It may also increase when using cholesterol-lowering medications.

Creatine Kinase (male) 25 - 90 U/L
Creatine Kinase (female) 10 - 70 U/L

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CK-MB CK isoenzyme - It begins to increase 6 to 10 hours after an acute MI, peaks in 24 hours, and remains elevated for up to 72 hours.

Creatine Kinase-MB 0 - 5 U/L

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(LDH) Lactate dehydrogenase - Total LDH will begin to rise 2 to 5 days after an MI; the elevation can last 10 days. LDH is an enzyme released in the blood with cell injury. It is used as a late marker to detect a heart attack. It is also elevated with liver and kidney disease, pernicious and megaloblastic anemias, malignancy, progressive muscular dystrophy and pulmonary emboli.

LDH 45 - 90 U/L

LDH-1 and LDH-2 LDH isoenzymes - Compare LDH 1 and LDH 2 levels. Normally, the LDH-1 value will be less than the LDH-2. In the acute MI, however, the LDH 2 remains constant, while LDH 1 rises. When the LDH 1 is higher than LDH 2, the LDH is said to be flipped, which is highly suggestive of an MI. A flipped pattern appears 12-24 hours post MI and persists for 48 hours.

LDH-1: 18 - 33 percent
LDH-2: 28 - 40 percent

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Alanine Aminotransferase (ALT; also called SGPT)- It is a liver enzyme and may increase when using cholesterol-lowering medications.

ALT 5 – 50 U/L

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SGOT - Serum glutamic oxaloacetic transaminase is an enzyme that is normally present in liver and heart cells. SGOT is released into blood when the liver or heart is damaged. The blood SGOT levels are elevated with liver damage (hepatitis) or with an insult to the heart (heart attack). There are some medications that can also raise SGOT levels. SGOT is also called aspartate aminotransferase (AST). SGOT will begin to rise in 8-12 hours and peak in 18-30 hours. SGOT is a liver enzyme that is released into the bloodstream following injury or death of cells. Increased SGOT or AST is seen with liver disease, myocardial infarction (MI) and some medications. May increase when using cholesterol-lowering medications.

SGOT aka AST 7 – 40 U/L

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Myoglobin - early and sensitive diagnosis of myocardial infarction in the emergency department This small heme protein becomes abnormal within 1 to 2 hours of necrosis, peaks in 4-8 hours, and drops to normal in about 12 hours. Myoglobin is a protein found in certain types of muscle. Elevated myoglobin may indicate muscle injury or inflammation.

Myoglobin, serum (male): 30 – 90 µg/ml
Myoglobin, serum (female): 30 – 90 µg/ml

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Troponin Complex - Peaks in 10-24 hours, begins to fall off after 1-2 weeks. Troponin T is a protein found in the blood and is related to contraction of the heart muscle. Troponin T is valuable for detecting heart muscle damage and risk.

Tropinin I: < 0.0 - 0.10 µg/mL
Tropinin T: < 0.0 - 0.10 µg/mL

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