The Importance of Creatine Kinase Determination in Identifying Acute Myocardial Infarction among Patients Complaining of Chest Pain in an Emergency Room

Cardiology ◽  
1987 ◽  
Vol 74 (2) ◽  
pp. 100-110 ◽  
Author(s):  
Sami Viskin ◽  
Karin Heller ◽  
David Gheva ◽  
Avi Hassner ◽  
Itzhak Shapira ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Chest Pain ◽  
Emergency Room

Creatine kinase radioimmunoassay and isoenzyme electrophoresis compared in the diagnosis of acute myocardial infarction.

1980 ◽  
Vol 26 (7) ◽  
pp. 861-866 ◽  
Author(s):  
H A Homburger ◽  
G L Jacob
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Chest Pain ◽  
Predictive Value ◽  
Positive Test ◽  
Test Results ◽  
Diagnostic Specificity ◽  
B Subunit ◽  
Creatine Kinase B

Abstract We compared, in 116 patients, the relative usefulness of results of tests for creatine kinase B isoenzymes, as measured by radioimmunoassay, and the MB isoenzyme, as measured by electrophoresis, in diagnosis of acute myocardial infarction. The radioimmunoassay was specific for isoenzymes of creatine kinase containing the B subunit. All patients with acute transmural infarcts had positive test results by both techniques, but concentrations of B-isoenzymes were more frequently above normal than were MB bands in the case of patients with acute subendocardial infarcts and in the case of all patients with acute myocardial infarcts from whom sera were collected more than 24 h after onset of chest pain. Concentrations of B-isoenzymes also were increased, even when MB bands were not electrophoretically detectable, in specimens from several patients without documented actue myocardial infarcts. These abnormal results presumably were caused by increased concentrations of the BB isoenzyme in serum. Accordingly, an increased concentration of B-isoenzymes had less diagnostic specificity and predictive value for acute myocardial infarction than did a detectable MB band. Results of isoenzyme electrophoresis were more reliable for establishing this diagnosis, but the results of radioimmunoassay were more reliable for excluding it in patients with chest pain as the primary symptom.

Activity of serum aspartate aminotransferase isoenzymes in patients with acute myocardial infarction.

1987 ◽  
Vol 33 (1) ◽  
pp. 67-71 ◽  
Author(s):  
M Panteghini ◽  
F Pagani ◽  
C Cuccia
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Chest Pain ◽  
Aspartate Aminotransferase ◽  
Biological Information ◽  
Serum Samples ◽  
The Third ◽  
Serum Aspartate Aminotransferase ◽  
Serial Serum

Abstract Activities of aspartate aminotransferase (AST) isoenzymes were determined in serial serum samples from 40 cases of acute myocardial infarction, and compared with activities of creatine kinase, CK-MB isoenzyme, lactate dehydrogenase, and alpha-hydroxybutyrate dehydrogenase for temporal changes. Cytosolic (soluble) AST (s-AST) and mitochondrial AST (m-AST) respectively increased 6.6 and 9.0 h after onset of chest pain. The median time at which serum m-AST activity peaked (15.8 U/L, range 6.4-53.5 U/L) was 47.8 h after the onset of infarction, 19.8 h later than the peak s-AST activity (171 U/L, range 53-517 U/L) and m-AST also disappeared from the serum more slowly than s-AST (p less than 0.001). Serum m-AST values were above normal for at least six days after the infarct. The ratio of m-AST to total AST in serum increased after myocardial infarction, being greatest (20%, range 11-32%) on the third day after onset. For individuals, peak activities of s-AST correlated well with total CK (r = 0.91) and CK-MB (r = 0.86) peak activities, indicating that s-AST also reflects the infarct size. However, m-AST correlated poorly with the enzymes commonly used in infarct diagnosis; it apparently provides different biological information.

Creatine Kinase MB Isoforms in Patients with Skeletal Muscle Injury: Ramifications for Early Detection of Acute Myocardial Infarction

1992 ◽  
Vol 38 (12) ◽  
pp. 2396-2400 ◽  
Author(s):  
A H Wu ◽  
X M Wang ◽  
T G Gornet ◽  
J Ordóñez-Llanos
Keyword(s):  
Myocardial Infarction ◽  
Skeletal Muscle ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Chest Pain ◽  
Muscle Injury ◽  
Skeletal Muscle Injury ◽  
Relative Index ◽  
Muscle Trauma ◽  
Normal Individuals

Abstract We measured total creatine kinase (CK), CK-MB isoenzyme, and the MB isoforms in 202 serum and plasma samples from nine groups of patients and normal individuals: 39 with acute myocardial infarction (MI), divided according to time between the onset of chest pain and blood collection (1-6 h, 7-12 h, and 13-48 h); 26 with chest pain for whom an MI was ruled out, sampled at admission; 17 undergoing bypass surgery or cardiac catheterization, sampled within 6 h after either procedure; 17 with acute skeletal muscle injury, sampled within 8 h after injury; 30 marathon runners immediately after a race; 17 runners and other athletes > 12 h after training or a race; 12 with cerebral injury or seizures, sampled at admission; 8 with closed head injury, sampled at admission; and 38 normal subjects. CK-MB (relative index) and MB isoforms (MB2/MB1) were respectively increased in 15% and 75% of MI patients 1-6 h after onset, 94% and 94% after 7-12 h, and 88% and 8% after 12 h, and in 87% and 82% of cardiac surgery patients. MB isoforms were increased in most patients with acute skeletal muscle trauma and in subjects examined after exercise, but were within normal limits in patients for whom MI was ruled out, patients with cerebral trauma, and normal individuals. The relative index of MB/total CK was normal in essentially all individuals in the last groups, including those with acute skeletal muscle trauma. We concluded that the CK-MB isoform ratio is increased in both acute skeletal muscle injury and MI. The isoform ratio is most useful for distinguishing recent from old (> 12 h) injury.

scholarly journals Thrombolysis on first contact saves minutes and myocardium

2020 ◽  
Vol 52 (4) ◽  
Author(s):  
Muhammad saad Jibran ◽  
Muhammad Irfan
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Emergency Room ◽  
Pain Clinic ◽  
P Value ◽  
Base Line ◽  
Chi Square ◽  
Cardiology Department ◽  
Chi Square Test

ABSTRACT OBJECTIVE: To compare the door to needle time (DNT), for thrombolysis in acute myocardial infarction, at the new chest pain clinic at emergency room, with the old CCU at the cardiology Department LRH Peshawar. METHODOLOGY: This was a retrospective study conducted at Lady reading Hospital, Peshawar. Two data sets were acquired from hospital records. One for CCU at the cardiology department covered the span from 1st July till 30th sept: 2010. The other for the chest pain clinic emergency department covered the span from 1st April to 15th May, 2017. All the patients having ST elevated acute myocardial infarction eligible for thrombolytic therapy were included in the study. Door to needle time was calculated in both the groups. Comparison of DNT between both groups was made by using student t-test with p-≤0.05 taken as significant. Comparison between other base line qualitative characteristics was made by using chi square test with p-≤0.05 taken as significant. RESULTS: Total of 140 patients were enrolled in CCU group with mean age of 57.96±13.5 years. Out of these 60% were male. While 209 patients were enrolled in ED group with mean age of 58.85±6.9 years. Of these 65.1% were males. Mean DNT in CCU group was 72.42±50.85 minutes while in ED was 31.96±16.6 minutes with p-value 0.0001 with a reduction of 41.30 minutes in the DNT. DNT of <30 minutes and between 30-60 minutes was achieved in 7.1% and 62.8% in CCU group while in rest it was more than 60 minutes. In ED group the DNT achieved was <30 minutes in70.8% and 30-60 minutes in 29.2% of patients while none fell in category of >60 minutes. CONCLUSION: The door to needle time for thrombolytic administration for acute myocardial infarction was significantly less at the chest pain clinic at emergency room than at the CCU at cardiology department.

Changes in the ratio of lactate dehydrogenase isoenzymes 1 and 2 during the first day after acute myocardial infarction.

1985 ◽  
Vol 31 (10) ◽  
pp. 1621-1624 ◽  
Author(s):  
G Jablonsky ◽  
F Y Leung ◽  
A R Henderson
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Chest Pain ◽  
Lactate Dehydrogenase ◽  
Normal Values ◽  
Cardiac Enzymes ◽  
Parallel Increase ◽  
Time Of Admission ◽  
Lactate Dehydrogenase Isoenzymes

Abstract It is known that the ratio of isoenzyme 1 to total lactate dehydrogenase (LD, EC 1.1.1.27) in serum is increased in all patients with acute myocardial infarction within 24 h of the infarct. We now show that the LD-1/LD-2 ratio for serum more promptly indicates acute myocardial infarction, being for most patients equivalent to measurement of creatine kinase (EC 2.7.3.2) isoenzyme 2 (CK-2, CK-MB) in serum. Of 128 patients with a confirmed diagnosis of myocardial infarction, 66 had normal values for all "cardiac" enzymes at the time of admission, but greater than 75% of them showed a parallel increase in values for CK-2 and the LD-1/LD-2 ratio. Of the 26 patients who had one or more abnormal values for cardiac enzymes on admission, 95% showed a parallel increase in CK-2 and the LD-1/LD-2 ratio, the median time for the beginning of these changes being 9 h from the onset of chest pain. The remaining 36 patients were excluded from the study because CK-2 decreased after admission or because the time of onset of chest pain was uncertain.

The Effect of Established β-Adrenoreceptor-Blocking Therapy on the Release of Cytosolic and Lysosomal Enzymes after Acute Myocardial Infarction in Man

1978 ◽  
Vol 55 (6) ◽  
pp. 549-553
Author(s):  
Elizabeth Welman ◽  
K. M. Fox ◽  
A. P. Selwyn ◽  
Brenda J. Carroll
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Chest Pain ◽  
Lysosomal Enzyme ◽  
Time Course ◽  
Venous Blood ◽  
Maximum Activity ◽  
Creatine Kinase Activity ◽  
Control Group

1. Serial venous blood samples were obtained from 45 patients with acute myocardial infarction. Ten of these patients were receiving β-adrenoreceptor-blocking drugs at the time of onset of chest pain and continued on these drugs during their stay in the coronary care unit. The activities of creatine kinase and its MB-isoenzyme (CK-MB) were assayed in the plasma. A lysosomal enzyme, β-N-acetylglucosaminidase, was also assayed. 2. In the 35 untreated patients it was found that creatine kinase activity was maximal at a mean time of 21.3 ± 1.3 h after the onset of chest pain, whereas in the patients receiving β-adrenoreceptor-blocking drugs peak activity of the enzyme occurred at 24.4 ± 0.7 h. 3. Peak CK-MB activity was also delayed from 18.1 ± 1.6 h in the control group to 22.4 ± 1.2 h in the treated patients. 4. The lysosomal enzyme showed a similar pattern of changes to that of CK-MB. Maximum activity in plasma occurred at 18.0 ± 1.0 h after the onset of chest pain in the control group of patients. In the treated patients peak lysosomal enzyme activity was not found until 24.2 ± 1.2 h. 5. These alterations in the time-course of plasma enzyme changes after acute myocardial infarction are consistent with the suggestion that β-receptor antagonists may delay tissue damage during myocardial ischaemia.

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