Time-dependent conversion of creatine kinase (CK) MM isoforms in acute myocardial infarction (AMI)

Abstract Lactate dehydrogenase (LD) isoenzymes 1 and 2 in human serum were separated on a column of diethylaminoethyl-Sephadex. Samples layered on mini-columns were eluted with buffered sodium chloride (100, 150, and 200 mmol/liter). Lactate dehydrogenase activity in column effluents was measured by the Wacker method, and their isoenzyme content was evaluated by electrophoresis on polyacrylamide gel. Results for column-fractionated LD-1 and LD-2 were expressed in two ways: LD-1/LD-2 ratios and total LD-1 + LD-2 activities. The former is a more specific indicator of myocardial infarction than the latter. Sera from 10 patients with acute myocardial infarction (increased creatine kinease isoenzyme MB activity) exhibited ratios in the range of 0.92 to 1.56, ratios for 10 patients without heart disease (normal creatine kinase MB) ranged from 0.33 to 0.69.

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Creatine kinase-MB fraction and cardiac troponin T to diagnose acute myocardial infarction after cardiopulmonary resuscitation

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(96)00316-6 ◽

1996 ◽

Vol 28 (5) ◽

pp. 1220-1225 ◽

Cited By ~ 44

Author(s):

Marcus Müllner ◽

Michael M. Hirschl ◽

Harald Herkner ◽

Fritz Sterz ◽

Thomas Leitha ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Creatine Kinase ◽

Cardiopulmonary Resuscitation ◽

Cardiac Troponin ◽

Troponin T ◽

Cardiac Troponin T ◽

Creatine Kinase Mb

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Is it possible to predict immediate efficacy of IV thrombolysis in acute myocardial infarction (MI) by creatine kinase measurement (CK)?

Thrombosis Research ◽

10.1016/0049-3848(92)90511-8 ◽

1992 ◽

Vol 65 ◽

pp. S98

Author(s):

F. Jan ◽

G. Pochmalicki ◽

B. Petit ◽

L. Feldman ◽

P. Hausfater ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Creatine Kinase

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Diagnostic Efficiency of Creatine Kinase (CK), CKMB, Troponin T and Troponin I in Patients with Suspected Acute Myocardial Infarction

JOURNAL OF HEALTH SCIENCE ◽

10.1248/jhs.52.180 ◽

2006 ◽

Vol 52 (2) ◽

pp. 180-185 ◽

Cited By ~ 7

Author(s):

Mohamad Khalid Nusier ◽

Bassam Mahmood Ababneh

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Creatine Kinase ◽

Troponin I ◽

Troponin T ◽

Diagnostic Efficiency ◽

Suspected Acute Myocardial Infarction

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Biochemical Markers of Myocardial Injury Test Turnaround Time: A College of American Pathologists Q-Probes Study of 7020 Troponin and 4368 Creatine Kinase–MB Determinations in 159 Institutions

Archives of Pathology & Laboratory Medicine ◽

10.5858/2004-128-158-bmomit ◽

2004 ◽

Vol 128 (2) ◽

pp. 158-164 ◽

Cited By ~ 2

Author(s):

David A. Novis ◽

Bruce A. Jones ◽

Jane C. Dale ◽

Molly K. Walsh

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Creatine Kinase ◽

Biochemical Markers ◽

Myocardial Injury ◽

Turnaround Time ◽

Test Results ◽

Cardiac Marker ◽

Laboratory Personnel ◽

Creatine Kinase Mb

Abstract Context.—Rapid diagnosis of acute myocardial infarction in patients presenting to emergency departments (EDs) with chest pain may determine the types, and predict the outcomes of, the therapy those patients receive. The amount of time consumed in establishing diagnoses of acute myocardial infarction may depend in part on that consumed in the generation of the blood test results measuring myocardial injury. Objective.—To determine the normative rates of turnaround time (TAT) for biochemical markers of myocardial injury and to examine hospital and laboratory practices associated with faster TATs. Design.—Laboratory personnel in institutions enrolled in the College of American Pathologists Q-Probes Program measured the order-to-report TATs for serum creatine kinase–MB and/or serum troponin (I or T) for patients presenting to their hospital EDs with symptoms of acute myocardial infarction. Laboratory personnel also completed detailed questionnaires characterizing their laboratories' and hospitals' practices related to testing for biochemical markers of myocardial injury. ED physicians completed questionnaires indicating their satisfaction with testing for biochemical markers of myocardial injury in their hospitals. Setting.—A total of 159 hospitals, predominantly located in the United States, participating in the College of American Pathologists Q-Probes Program. Results.—Most (82%) laboratory participants indicated that they believed a reasonable order-to-report TATs for biochemical markers of myocardial injury to be 60 minutes or less. Most (75%) of the 1352 ED physicians who completed satisfaction questionnaires believed that the results of tests measuring myocardial injury should be reported back to them in 45 minutes or less, measured from the time that they ordered those tests. Participants submitted TAT data for 7020 troponin and 4368 creatine kinase–MB determinations. On average, they reported 90% of myocardial injury marker results in slightly more than 90 minutes measured from the time that those tests were ordered. Among the fastest performing 25% of participants (75th percentile and above), median order-to-report troponin and creatine kinase–MB TATs were equal to 50 and 48.3 minutes or less, respectively. Shorter troponin TATs were associated with performing cardiac marker studies in EDs or other peripheral laboratories compared to (1) performing tests in central hospital laboratories, and (2) having cardiac marker specimens obtained by laboratory rather than by nonlaboratory personnel. Conclusion.—The TAT expectations of the ED physicians using the results of laboratory tests measuring myocardial injury exceed those of the laboratory personnel providing the results of those tests. The actual TATs of myocardial injury testing meet the expectations of neither the providers of those tests nor the users of those test results. Improving TAT performance will require that the providers and users of laboratory services work together to develop standards that meet the needs of the medical staff and that are reasonably achievable by laboratory personnel.

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Analyses of creatine kinase isoenzymes and isoforms in serum to detect reperfusion after acute myocardial infarction.

Clinical Chemistry ◽

10.1093/clinchem/33.4.507 ◽

1987 ◽

Vol 33 (4) ◽

pp. 507-511 ◽

Cited By ~ 26

Author(s):

F S Apple ◽

S W Sharkey ◽

M Werdick ◽

K J Elsperger ◽

R T Tilbury

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Creatine Kinase ◽

Clearance Rates ◽

Creatine Kinase Isoenzymes

Abstract Isoenzymes and isoforms of creatine kinase (CK, EC 2.7.3.2) were measured to assess reperfusion after acute myocardial infarction (AMI). In streptokinase-treated and in spontaneously reperfused AMI patients, total CK, CK-2 activity and concentration, and CK-3(3) isoform activity peaked significantly (p less than 0.05) earlier than conventionally treated, non-reperfused patients. The ratio for CK-3(3) to CK-3(1) activities peaked significantly (p less than 0.05) earlier in both the streptokinase-treated and spontaneously reperfused groups, and indicated a greater release of enzyme (higher ratio) than in the conventionally treated patients. The ratio of CK-3(3)/3(1) also peaked significantly (p less than 0.05) earlier in all three groups than did total CK, CK-2, and CK-3(3) activities or concentrations. The clearance rates of total CK, CK-2, and CK-3(3) were not significantly different in all three groups. Thus, the ratio CK-3(3)/3(1) was the earliest indicator of infarction in both reperfused and non-reperfused patients.

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Diagnostic efficacy of a new enzyme immunoassay for creatine kinase MB isoenzyme.

Clinical Chemistry ◽

10.1093/clinchem/30.8.1399 ◽

1984 ◽

Vol 30 (8) ◽

pp. 1399-1401 ◽

Cited By ~ 4

Author(s):

J J Fenton ◽

S Brunstetter ◽

W C Gordon ◽

D F Rippe ◽

M L Bell

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Creatine Kinase ◽

Enzyme Immunoassay ◽

Solid Phase ◽

Correct Diagnosis ◽

Diagnostic Efficacy ◽

Creatine Kinase Mb ◽

Sandwich Type ◽

Sensitivity Specificity

Abstract A new commercial enzyme immunoassay kit for quantification of creatine kinase-MB (CK-MB) isoenzyme was compared with its electrophoretic determination with respect to efficacy in diagnosis of acute myocardial infarction. Enzygnost CK-MB (Behring Diagnostics) is a solid-phase "sandwich"-type enzyme immunoassay with antibodies to the B-subunit coated on plastic tubes and peroxidase-conjugated antibodies to the M-subunit added after incubation with sample. This kit is designed to measure only CK-MB and not CK-MM, CK-BB, adenylate kinase, or atypical CK molecules. The linear-regression equation comparing the two methods was: Enzygnost = 0.98 . electrophoresis - 0.72, with a correlation coefficient of r = 0.967 (n = 143). For 51 patients admitted for diagnosis of possible acute myocardial infarction, the Enzygnost kit achieved 100% sensitivity, specificity, and efficiency in predicting the correct diagnosis. Corresponding values for the electrophoretic assay were: 95.5% sensitivity, 93.1% specificity, and 94.1% efficiency. We conclude that this kit method provides an excellent alternative to electrophoresis.

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