Acute cardiac rejection involves myocyte necrosis. Hence, markers of myocyte death may be useful in diagnosing rejection. Creatine kinase MB, MB isoforms, and troponins I and T were measured in 186 patients undergoing 365 endomyocardial biopsies. No differences were noted with rejection (rejectors vs. nonrejectors: CK=63.8 U/L and 86.6 U/L, P=0.0881; CK MB=2.04 ng/ml and 2.06 ng/ml, P=0.949; troponin T=0.134 ng/ml and 0.0881 ng/ml, P=0.374; troponin I=0.216 ng/ml and 0.707 ng/ml, P=0.357). The time course of troponins T and I levels in rejectors and nonrejectors do not differ with both groups having early elevations. Markers of myocyte death are inadequate predictors of acute rejection in cardiac allografts. The time course of troponins T and I suggests a possible role as prognostic indicators of outcome.
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