Biomarker creatine

Coal-handling workers at a coke oven who were exposed to coal-tar sludge (67% coal tar) through dermal contact had increased urinary 1-hydroxypyrene concentrations following work shifts (Malkin et al. 1996). Urinary concentrations of the biomarker increased from a preshift mean of 1.00 pmol/mol creatine to a postshift level of 1.7 pmol/mol creatine. The increases were attributed to dermal exposure, as exposure to volatile pyrene was determined to be minimal. 

A review paper of studies using the concentration in urine of 1-hydroxypyrene as a biomarker of PAH exposure included levels reported in various studies (Strickland et al. 1996). The respective pre- and postshift urinary excretion levels of 1-hydroxypyrene for coke oven workers were 0.89 and 2.47 pmol/mol creatine for asphalt pavers, respective levels were 1.35 and 1.76 pmol/mol creatine. 

Diagnosis of cardiac muscle injury relies on the detection of biomarkers such as troponin I (Tnl), troponin C (TnC), myoglobin, fatty acid binding protein (FABP), glycogen phosporylase isoenzyeme BB (GPBB), C-reactive protein (CP), urinary albumin, creatine kinase myocardial band (CK-MB), and brain (B-type) natriuretic peptide in blood and urine [28-30]. 

In the acute setting of cocaine-induced chest pain, assessment includes the possible diagnosis of acute myocardial infarction. However, cocaine may independently affect cardiac biomarkers [22 ]. Recent cocaine use may alter the specificity of measurement of serum creatine kinase and its MB Iraction. Among cocaine users, increased serum creatine kinase activities and increased mean myoglobin concentrations are common. Increased skeletal muscle activity and rhab-domyolysis are often present, possibly because of cocaine-induced hyperthermia. Troponin I concentrations are more reliable cardiac biomarkers for detecting cocaine-induced myocardial infarction and are associated with a poor prognosis. 

Serum biomarkers of acute coronary syndrome play a critical role in the diagnosis and risk stratification of patients with ACS. Myocardial necrosis observed in patients with ACS releases a variety of proteins into blood that can be used as biomarkers. Antiquated markers include aspartate aminotransferase, lactate dehydrogenase (LD) and its isoenzyme (LDl), myoglobin, and creatine kinase (CK) and its isoenzyme (CK-MB). While some of these markers are still in routine use, there is consensus among experts in the field of cardiology, emergency medicine, and laboratory medicine that cardiac troponin is the gold standard marker for ACS. 

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