Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (1083 page)

   Male: 28–72 ng/mL

   Female: 25–58 ng/mL

   Use

   A cardiac biomarker, myoglobin is the one of the earliest markers for myocardial necrosis.

   Myoglobin levels start to rise within 2–3 hours of myocardial infarction, reach their highest levels within 8–12 hours, and generally fall back to normal within 1 day.

   A negative myoglobin result effectively rules out a heart attack, but a positive result must be confirmed by testing for troponin or another biomarker.

   Sensitivity is >95% within 6 hours of onset of symptoms.

   Myoglobin may precede release of CK-MB by 2–5 hours.

   Interpretation

   Within 1–3 hours in >85% of patients with AMI, myoglobin peaks in about 8–12 hours (may peak within 1 hour) to about 10 times the upper reference limit and becomes normal in about 24–36 hours or less; reperfusion causes a peak 4–6 hours earlier.

   It is also increased in

   Renal failure (high levels of urine myoglobin indicate an increased risk of kidney damage.)

   Shock