Don’t ask for AST, LDH, total CK, CK-MB or myoglobin for the diagnosis of acute myocardial infarction.

Type of practice

Laboratory tests

The only laboratory test that really contributes to the diagnosis of acute myocardial infarction is the cardiac troponin (I or T). Especially with the more recent formulations at elevated analytical sensitivity this test presents characteristics of diagnostic specificity and sensitivity higher than any other diagnostic test presently available.


1. Hamm CW, et al. ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. European Hearth Journal 2011; 32: 2999-3054.
2. Panteghini M, Belloni A, Botta M, et al. Strategie per l’impiego ottimale dei biomarcatori cardiaci: raccomandazioni e protocolli operativi. Biochim Clin 2005; 29: 419-28.
3. Thygesen K, Alpert JS, Jaffe AS, et al. on behalf of the Joint ESC/ACCF/AHA/WHF task force for the universal definition of myocardial infarction. Third universal definition of myocardial infarction. J Am Coll Cardiol 2012; 60: 1581-98.

Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.