CAP Pro Course - Chemistry - Cardiac Biomarkers (2025 & 2026)

Author: Lynne Brodeur, MA, MLS(ASCP)CM
Reviewer: Laurie Bjerklie, MA, MLS(ASCP)CM

Continuing Education Credits

Objectives

  • List common tests used to assess acute cardiovascular injury in the acute care setting.
  • Compare and contrast troponin with high-sensitivity troponin (hsTn) assays.
  • Describe the current role of creatine kinase (CK) and creatine kinase MB isoform (CK-MB) testing in acute cardiovascular disease.
  • State the clinical significance of brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) measurement and discuss the differences between these two analytes.
  • Discuss the role of BNP and hsTn as cardiovascular risk markers rather than their established role as markers of myocardial infarction.
  • Explain how cardiac biomarkers are used in critical care diagnosis, risk stratification, and therapy monitoring.
  • Discuss the preanalytical, analytical, and postanalytical requirements for meeting quality standards for cardiac biomarker testing.

Course Outline

  • List common tests used to assess acute cardiovascular injury in the acute care setting.
      • Cardiac Biomarkers
      • Cardiac Biomarkers, continued
      • Congestive Heart Failure
      • A hospital laboratorian is given several different test samples to run. These include samples with tests for thyroid-stimulating hormone (TSH), blood ...
      • A patient presents to the emergency department (ED) with symptoms of shortness of breath and chest pain. Which one of these laboratory tests would be ...
      • A troponin test is usually a critical test for which of the following reasons?
  • Compare and contrast troponin with high-sensitivity troponin (hsTn) assays.
      • Troponin
      • Troponin, continued
      • Troponin Assay Performance
      • High-sensitivity Troponin (hsTn)
      • A clinician is writing new guidelines for acute myocardial infarction (MI) patients and calls your laboratory to ask what generation of troponin assay...
      • A clinician calls the laboratory to inquire what type of troponin assay is being used by the lab. The lab uses a troponin-I (TnI) immunoassay. Which o...
      • Which of the following statements is true of high-sensitivity troponin tests?
  • Describe the current role of creatine kinase (CK) and creatine kinase MB isoform (CK-MB) testing in acute cardiovascular disease.
      • Creatine Kinase-MB
      • Creatine Kinase-MB, continued
      • A laboratorian must order proficiency testing for the lab which performs both total creatine kinase (CK) and creatine kinase MB isoform (CK-MB) measur...
      • A sample that was tested for CK-MB is placed in a self-defrosting freezer that causes the sample to go through periodic freeze/thaw cycles. If the sam...
  • State the clinical significance of brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) measurement and discuss the differences between these two analytes.
      • BNP and NT-proBNP
      • BNP versus NT-proBNP
      • Using Natriuretic Peptide Measurements
      • A clinician orders three brain natriuretic peptide (BNP) measurements in two days on a patient. The patient's BNP value fluctuated from 70 to 90 and t...
      • A laboratory recently changed its BNP assay to use another vendor assay for NT-proBNP. Clinicians have been notified about the change before it went i...
      • Which of the following is a true statement?
  • Discuss the role of BNP and hsTn as cardiovascular risk markers rather than their established role as markers of myocardial infarction.
      • Risk Markers
      • hsTn as a Risk Marker
      • BNP and NT-proBNP as Risk Markers
      • How does age affect BNP and NT-proBNP levels?
      • Which subunits of troponin are used for identifying cardiac disorders?
      • Which of the following is a true statement?
  • Explain how cardiac biomarkers are used in critical care diagnosis, risk stratification, and therapy monitoring.
      • Atherosclerosis and Progression to Acute Myocardial Infarction (AMI)
      • Differential Diagnosis of Acute Myocardial Infarction (AMI)
      • The manufacturer of a particular BNP test states that the BNP test has a high negative predictive value for CHF. What does this mean?
      • A patient presents to the ED with symptoms of shortness of breath and chest pain. Which of these statements is true regarding this patient?
  • Discuss the preanalytical, analytical, and postanalytical requirements for meeting quality standards for cardiac biomarker testing.
      • Quality Standards of Cardiac Marker Testing
      • Critical Care Reporting of Results
      • A blood sample for cardiac troponin (cTn) testing is received from the emergency department (ED). The facility's chest pain protocol requires all card...
      • A blood sample for cardiac troponin (cTn) testing is received from the emergency department (ED). The facility's chest pain protocol requires all card...
  • References
      • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: This program is designed as an educational and training tool for MLS and MLT personnel, medical laboratory science students, pathology residents, and practicing pathologists.
Author Information: Lynne Brodeur, MA, MLS(ASCP)CM, holds a master of arts degree in teaching. She is a full-time lecturer at the University of Massachusetts Dartmouth and works per diem in Clinical Chemistry at St. Luke's Hospital in New Bedford, MA.
Reviewer Information: Laurie Bjerklie, MA, MLS(ASCP)CM, is currently an Education Developer. She earned a B.S. in Medical Laboratory Science from the University of North Dakota and an M.A. in Curriculum and Instruction from Saint Xavier University. She has over 15 years of experience in higher education and has held program director and faculty positions in both MLT and MLS programs.

This course is part of the CAP Competency Assessment Hub.

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