Myocardial Infarction and AST Elevation

Mechanism and Frequency of AST Elevation in MI

The American College of Cardiology states that AST is no longer recommended for diagnosing MI because it lacks cardiac specificity 1

The American College of Cardiology recommends that cardiac troponin (I or T) has replaced AST as the preferred biomarker for MI diagnosis because of its superior myocardial tissue specificity and sensitivity 1, 2
The American College of Cardiology explicitly states that glutamic-oxaloacetic transaminase (ASAT/AST) should NOT be used to diagnose cardiac damage 1
The American College of Cardiology recommends that cardiac troponin exceeding the 99th percentile is the diagnostic standard for MI 2, 3
The American College of Cardiology suggests that CK-MB is the best alternative when troponin assays are unavailable, but total CK and transaminases are not recommended 1

The American College of Cardiology notes that AST can remain elevated for days after MI, complicating the timing of the event 1
The American College of Cardiology warns that AST elevation is not specific to cardiac injury—liver disease, skeletal muscle injury, hemolysis, and other conditions can elevate AST 1