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MyoglobinCK-MB Troponin I Rapid
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SUMMARY 
Myoglobin (MYO), Creatine Kinase MB (CK-MB) and cardiac Troponin I (cTnI) are proteins released into the bloodstream after cardiac injury. Myoglobin is a heme-protein normally found in skeletal and cardiac muscle with a molecular weight of 17.8 kDa. When muscle cells are damaged, Myoglobin is released into the blood rapidly due to its relatively small size. The level of Myoglobin increases measurably above baseline within 2-4 hours post-infarct, peaking at 9-12 hours, and returning to baseline within 24-36 hours. CK-MB is an enzyme also present in the cardiac muscle, with a molecular weight of 87.0 kDa. Creatine Kinase is a dimeric molecule formed from two subunits designated as “M” and “B”, which combine to form three different isoenzymes, CK-MM, CK-BB and CK-MB. CK-MB is the isoenzyme of Creatine Kinase most involved in the metabolism of cardiac muscle tissue. The release of CK-MB into the blood following an MI can be detected within 3-8 hours after the onset of symptoms. It peaks within 9 to 30 hours, and returns to baseline levels within 48 to 72 hours. Cardiac Troponin I is a protein found in cardiac muscle, with a molecular weight of 22.5 kDa. Troponin I is part of a three subunit complex comprised of Troponin T and Troponin C. Along with tropomyosin, this structural complex forms the main component that regulates the calcium sensitive ATPase activity of actomyosin in striated skeletal and cardiac muscle. After cardiac injury occurs, Troponin I is released into the blood 4-6 hours after the onset of pain. The release pattern of Troponin I is similar to CK-MB, but while CK-MB levels return to normal after 72 hours, Troponin I remains elevated for 6-10 days, thus providing for a longer window of detection for cardiac injury. 
The Myoglobin/CK-MB/Troponin I Combo Rapid Test Cassette (Whole Blood/Serum/Plasma) is a simple test that utilizes a combination of antibody coated particles and capture reagents to qualitatively detect Myoglobin, CK-MB and cardiac Troponin I (cTnI) in whole blood, serum or plasma. The minimum detection level is 50ng/mL Myoglobin, 5ng/mL CK-MB and 0.5ng/mL Troponin I. 

DIRECTIONS FOR USE 
Allow the test cassette, specimen, buffer and/or controls to reach room temperature (15-30°C) prior to testing. 
1. Bring the pouch to room temperature before opening it. Remove the test cassette from the sealed pouch and use it as soon as possible. 
2. Place the cassette on a clean and level surface. 
For Serum or Plasma specimen: 
· Hold the dropper vertically and transfer 2 drops of serum or plasma (approximately 50µL) to the specimen well, then add 1 drop of buffer (approximately 40µL), and start the timer. See illustration below. 
For Venipuncture Whole Blood specimen: 
· Hold the dropper vertically and transfer 2 drops of whole blood (approximately 50µL) to the specimen well, then add 1 drop of buffer (approximately 40µL), and start the timer. See illustration below. 
For Fingerstick Whole Blood specimen: 
· To use a capillary tube: Fill the capillary tube and transfer approximately 50µL of fingerstick whole blood specimen to the specimen well of test cassette, then add 1 drop of buffer (approximately 40µL) and start the timer. See illustration below. 
· To use hanging drops: Allow 2 hanging drops of fingerstick whole blood specimen (approximately 50 µL) to fall into the specimen area of test cassette, then add 1 drop of buffer (approximately 40µL) and start the timer. See illustration below.

3. Wait for the colored line(s) to appear. Read result at 10 minutes. Do not interpret the result after 20 minutes.