Laboratory study Description and purpose Normal and diagnostic ranges

CK-MB CK-MB is a cardiospecific isoenzyme that is
released in the presence of myocardial tissue
injury. This test is used to support the
diagnosis of myocardial infarction.
Cardiac troponin (contractile Both Troponin I and Troponin T are highly
protein) specific to cardiac tissue and are released
from a MI.
Concentrations >4-6% of total CK are highly
indicative of myocardial infarction (MI).
Serum levels increase within 4 to 6 hrs after
MI, peaks within 18 hrs, and returns to
normal within 2 days.
Troponin I: Serum levels increase within 4 to
6 hrs after an MI, peaks within 10 to 24 hrs,
and returns to normal within 4 days.

Negative: <0.5 mcg/L

Indeterminant or suspicious for injury to

myocardium: 0.5 to 2.3 mcg/L

Positive for myocardial injury: >2.3

mcg/L

Troponin T: Serum levels increase within 4 to

6 hrs after an MI, peaks within 10 to 24 hrs,
and returns to normal within 10 days.

Negative: <0.1 mcg/L

Myoglobin Myoglobin is a low-molecular-weight protein
that is 99 to 100% sensitive for myocardial
injury.
Serum concentrations of myoglobin rise 30
to 60 min after MI. It is cleared from the
circulation rapidly. This test is most
diagnostic if measured within the first 12 hrs
of onset of chest pain.

Normal ranges:
Male: 15 to 91.2 mcg/L
Female: 11.1 to 57.5 mcg/L
Lipid Panel The lipid profile test measures the cholesterol
levels plus triglycerides.

Cholesterol is a blood lipid. Elevated Cholesterol levels can be obtained in a

cholesterol is considered a risk factor for nonfasting state.
artherosclerotic heart disease. Normal range:
<5.18 mmol/L (Varies with age and
gender)
Lipoproteins (HDL, LDL): Electrophoresis is
done to separate lipoproteins into HDL and
LDL. There are marked day-to-day variations
in serum lipid levels; more than one test is
needed for accurate diagnosis and
treatment.
HDL
HDL (high-density lipoprotein) helps move Recommended:
cholesterol out of the body/it binds with Male: >1.04 mmol/L
cholesterol in the bloodstream and transport Female: >1.3 mmol/L
cholesterol back to the liver for disposal. A Low risk for CAD:
high HDL level is linked with a lower risk of >1.55 mmol/L
coronary artery disease (CAD) High risk for CAD:
<1.04 mmol/L

LDL (low-density lipoprotein) carries mostly fat LDL

and only a small amount of protein from the Recommended:
liver to other parts of the body. High levels of <2.6 mmol/L
LDL is linked with increased risk of developing Near optimal:
CAD. 2.6 to 3.34 mmol/L
Moderate risk for CAD:
3.37 to 4.12 mmol/L
High risk for CAD:
>4.14 mmol/L

Triglycerides are mixtures of fatty acids. Triglycerides levels and lipoproteins must be
Elevations are associated with cardiovascular obtained in a fasting state (at least 12 hr,
disease and diabetes. except for water); alcohol should not be
consumed for 24 hrs before testing.

Normal range:
<1.7 mmol/L (varies with age)

Complete blood count (CBC) A CBC is a series of tests used to evaluate the See Table 1.3
composition and concentration of the cellular
components of blood. A CBC can help ascertain whether patients
It measures the following: presenting with chronic stable angina
The number of red blood cells (RBCs) reflect a gradual progression of obstructive
The number of white blood cells (WBCs) CAD or an increase in suplly/demand
The total amount of hemoglobin in the mismatch precipitated by a change in
blood activity or concurrent illness (such as
The fraction of blood composed of red anemia or infection), or whether they
blood cells (hematocrit) represent an acute coronary syndrome
The mean corpuscular volume (MCV) or (most likely due to an unstable plaque
the size of the red blood cells. cause acute thrombosis).

The CBC is used for the following purposes:
As a preoperative test to ensure both
adequate oxygen carrying capacity and
hemostasis
To check for infection
To diagnose anemia
To identify acute and chronic illness,
bleeding tendencies, and WBC disorders
(i.e., leukemia)
To monitor treatment of anemia and other
blood disorders
To determine the effects of chemotherapy
and radiation therapy on blood cell
production
C-reactive protein (CRP) This is a marker of inflammation; it can predict High sensitivity CRP assay used:
risk of cardiac disease, even in patients with Lowest risk:
normal lipid values. <1mg/L
Moderate risk:
CRP are stable levels that can be measured 1-3 mg/L
nonfasting and at any time. It may be a more High risk:
predictive risk factor of cardiac disease than >3 mg/L
LDLs for women.
Homocysteine Homocysteine is an amino acid produced Normal ranges:
during protein catabolism. It has been Male:
identified as a risk factor for cardiovascular 5.2 to 12.9 micromol/L
disease; it may cause damage to the Female:
endothelium or have a role in formation of 3.7 to 10.4 micromol/L
thrombi.
Hyperhomocysteinemia resulting from
dietary deficiencies is treated with folic
acid, vitamin B6, and vitamin B12
supplements.