Increased creatine kinase isoenzyme MB values in patients without myocardial infarct.

1978 ◽  
Vol 24 (10) ◽  
pp. 1818-1821 ◽  
Author(s):  
L M Shaw ◽  
D A Newman
Keyword(s):  
Myocardial Infarction ◽  
Intensive Care Unit ◽  
Creatine Kinase ◽  
Medical Intensive Care Unit ◽  
Myocardial Infarct ◽  
Creatine Kinase Isoenzyme ◽  
Creatine Kinase Mb ◽  
Medical Intensive Care ◽  
Column Procedure ◽  
Creatine Kinase Isoenzyme Mb

Abstract Six of 13 randomly selected patients in a medical intensive-care unit with above-normal creatine kinase MB activities had diagnoses other than myocardial infarction. These data, which indicate the need for further study, were obtained during evaluation of a commercially available column procedure (Biodynamics/bmc).

Clinical evaluation of an immunoinhibition procedure for creatine kinase-MB.

1980 ◽  
Vol 26 (1) ◽  
pp. 150-152
Author(s):  
D Obzansky ◽  
J A Lott
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Sensitivity And Specificity ◽  
Clinical Evaluation ◽  
Creatine Kinase Isoenzyme ◽  
Creatine Kinase Mb ◽  
Diagnostic Sensitivity And Specificity ◽  
Creatine Kinase Isoenzyme Mb

Abstract We have clinically evaluated the Dade "Cardiozyme" immunoinhibition procedure for determination of creatine kinase isoenzyme MB (CK-MG) in 71 patients who were suspected of having had an acute myocardial infarction. Electrophoresis for CK-MB was also carried out. On the basis of diagnostic sensitivity and specificity for myocardial infarction, we found the Dade procedure for CK-MB to be somewhat inferior to electrophoresis. In 11 patients for whom the time of infarction was known, we observed normal CK-MB results for two of them by both immunoinhibition and electrophoresis during the first 24 h, but subsequently could detect abnormal CK-MB results by both methods. Thus in some patients such data are not helpful for making a diagnosis in the first 24 h. The Dade procedure is easy to perform, but lacks sensitivity in the region of low CK-MB activity, requires a very stable spectrophotometer, is imprecise, and produces negative numerical results in patients without myocardial infarction.

Automated creatine kinase-MB estimation by immuno-inhibition: a clinical evaluation.

1980 ◽  
Vol 26 (5) ◽  
pp. 568-572 ◽  
Author(s):  
T J Delahunty ◽  
C C Foreback
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Lactate Dehydrogenase ◽  
Predictive Value ◽  
Myocardial Infarct ◽  
Creatine Kinase Isoenzyme ◽  
A Value ◽  
Creatine Kinase Mb ◽  
Coronary Care ◽  
Electrophoresis Technique

Abstract We detected the presence of creatine kinase (EC 2.7.3.2) MB isoenzyme (CK-MB) in serum by using an immunoinhibition technique to inactivate the creatine kinase isoenzyme of muscle origin (CK-MM). The GEMSAEC centrifugal analyzer is ideally suited for this procedure because it rapidly mixes reagents and has a throughput of 60 samples/h. The within-run CV was acceptable when the CK-MB value was 7.5 U/L or more. CK-MM was totally inactivated up to 5000 U/L, a value well above that usually seen in myocardial-infarct patients. We assessed the predictability of the assay for detecting myocardial infarction among 120 coronary-care patients when 2% of total CK activity was considered diagnostic and compared the results with those obtained with an electrophoresis technique. The positive predictive value of the immunoinhibition assay was 97.8%, as compared to 92% with the CK electrophoresis technique, when lactate dehydrogenase (EC 1.1.1.27) isoenzyme results were included in both cases. The optimal negative predictive value was 95.1% with the immunoinhibition assay vs 98.2% with electrophoresis. We conclude that the immunoinhibition technique for estimating CK-MB can be automated to assess myocardial status rapidly, precisely, inexpensively, and sensitively.

Automated creatine kinase-MB estimation by immuno-inhibition: a clinical evaluation.

1980 ◽  
Vol 26 (5) ◽  
pp. 568-572
Author(s):  
T J Delahunty ◽  
C C Foreback
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Lactate Dehydrogenase ◽  
Predictive Value ◽  
Myocardial Infarct ◽  
Creatine Kinase Isoenzyme ◽  
A Value ◽  
Creatine Kinase Mb ◽  
Coronary Care ◽  
Electrophoresis Technique

Abstract We detected the presence of creatine kinase (EC 2.7.3.2) MB isoenzyme (CK-MB) in serum by using an immunoinhibition technique to inactivate the creatine kinase isoenzyme of muscle origin (CK-MM). The GEMSAEC centrifugal analyzer is ideally suited for this procedure because it rapidly mixes reagents and has a throughput of 60 samples/h. The within-run CV was acceptable when the CK-MB value was 7.5 U/L or more. CK-MM was totally inactivated up to 5000 U/L, a value well above that usually seen in myocardial-infarct patients. We assessed the predictability of the assay for detecting myocardial infarction among 120 coronary-care patients when 2% of total CK activity was considered diagnostic and compared the results with those obtained with an electrophoresis technique. The positive predictive value of the immunoinhibition assay was 97.8%, as compared to 92% with the CK electrophoresis technique, when lactate dehydrogenase (EC 1.1.1.27) isoenzyme results were included in both cases. The optimal negative predictive value was 95.1% with the immunoinhibition assay vs 98.2% with electrophoresis. We conclude that the immunoinhibition technique for estimating CK-MB can be automated to assess myocardial status rapidly, precisely, inexpensively, and sensitively.

Clinical evaluation of an immunoinhibition procedure for creatine kinase-MB.

1980 ◽  
Vol 26 (1) ◽  
pp. 150-152 ◽  
Author(s):  
D Obzansky ◽  
J A Lott
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Sensitivity And Specificity ◽  
Clinical Evaluation ◽  
Creatine Kinase Isoenzyme ◽  
Creatine Kinase Mb ◽  
Diagnostic Sensitivity And Specificity ◽  
Creatine Kinase Isoenzyme Mb

Abstract We have clinically evaluated the Dade "Cardiozyme" immunoinhibition procedure for determination of creatine kinase isoenzyme MB (CK-MG) in 71 patients who were suspected of having had an acute myocardial infarction. Electrophoresis for CK-MB was also carried out. On the basis of diagnostic sensitivity and specificity for myocardial infarction, we found the Dade procedure for CK-MB to be somewhat inferior to electrophoresis. In 11 patients for whom the time of infarction was known, we observed normal CK-MB results for two of them by both immunoinhibition and electrophoresis during the first 24 h, but subsequently could detect abnormal CK-MB results by both methods. Thus in some patients such data are not helpful for making a diagnosis in the first 24 h. The Dade procedure is easy to perform, but lacks sensitivity in the region of low CK-MB activity, requires a very stable spectrophotometer, is imprecise, and produces negative numerical results in patients without myocardial infarction.

Diagnosis of acute myocardial infarction from two measurements of creatine kinase isoenzyme MB with use of nonparametric probability estimation.

1989 ◽  
Vol 35 (3) ◽  
pp. 444-447 ◽  
Author(s):  
L H Bernstein ◽  
I J Good ◽  
G I Holtzman ◽  
M L Deaton ◽  
J Babb
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Bayes Factors ◽  
Probability Estimation ◽  
Posterior Odds ◽  
Creatine Kinase Isoenzyme ◽  
Time Of Admission ◽  
Bivariate Probability ◽  
Creatine Kinase Isoenzyme Mb

Abstract By using bivariate probability estimation for the diagnosis of acute myocardial infarction (AMI) we show how to overcome the difficulties encountered for patients whose clinical presentation is atypical and those encountered when multiple isoenzyme determinations are treated by univariate methods. We use the values for creatine kinase isoenzyme MB measured at the time of admission and 12 h later to estimate the Bayes factors in favor of AMI. The Bayes factors are compiled into a table that the clinician can use to estimate the posterior probability that a patient has AMI. The table of Bayes factors is based on data for a sample of 802 non-AMI patients and 180 AMI patients. Further to validate the method, we randomly chose 200 of the non-AMI and 50 of the AMI patients as an evaluation sample, then used the remaining 602 non-AMI and 130 AMI patients to recompute the Bayes factors. These Bayes factors were used to find the probability of AMI for each of the 250 patients in the evaluation sample. The method resulted in only one false positive and no false negatives. For the misclassified patient the measurements at admission and 12 h later were 1 and 11 U/L; the posterior odds were 15 to 1 in favor of AMI, but in fact the patient was non-AMI.

Increased activity of creatine kinase isoenzyme MB in a theophylline-intoxicated patient.

1985 ◽  
Vol 31 (10) ◽  
pp. 1741-1742 ◽  
Author(s):  
R H Ng ◽  
C Roe ◽  
D Funt ◽  
B E Statland
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Time Course ◽  
Clinical Findings ◽  
Creatine Kinase Isoenzyme ◽  
Increased Activity ◽  
Theophylline Intoxication ◽  
Creatine Kinase Isoenzyme Mb

Abstract A 78-year-old woman had increased activities of creatine kinase (CK; EC 2.7.3.2) and CK-MB isoenzyme in her serum, associated with severe theophylline intoxication. The time course for CK-MB activity was similar to that from an acute myocardial infarction. Clinical findings, however, including electrocardiograms, did not support the diagnosis of myocardial infarction. We suggest caution in interpreting CK-MB results in severe theophylline intoxication.

Aberrant creatine kinase and lactate dehydrogenase response in a myocardial infarct patient.

1984 ◽  
Vol 30 (10) ◽  
pp. 1708-1709
Author(s):  
D L Smalley ◽  
B Womack ◽  
C Handorf ◽  
S Acchiardo
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Lactate Dehydrogenase ◽  
Dehydrogenase Activity ◽  
Normal Values ◽  
Myocardial Infarct ◽  
Total Activity ◽  
Lactate Dehydrogenase Activity ◽  
Creatine Kinase Mb ◽  
Isoenzyme Patterns

Abstract A 65-year-old woman failed to develop increased creatine kinase or lactate dehydrogenase activity after a myocardial infarction. She had no measurable creatine kinase MB isoenzyme and no detectable patterns of normal LD isoenzyme activity. These determinations five months after the infarction showed normal values for total activity and isoenzyme patterns.

Stability and electrophoretic characteristics of creatine kinase BB extracted from human brain and intestine.

1988 ◽  
Vol 34 (3) ◽  
pp. 489-492 ◽  
Author(s):  
S L Chastain ◽  
C H Ketchum ◽  
W E Grizzle
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Human Brain ◽  
False Positive ◽  
Human Intestine ◽  
Electrophoretic Variant ◽  
Creatine Kinase Isoenzyme ◽  
Creatine Kinase Bb ◽  
Similar Development ◽  
Creatine Kinase Isoenzyme Mb

Abstract Creatine kinase (CK; EC 2.7.3.2) isoenzyme BB extracted from brains of rats reportedly undergoes modification at 37 degrees C, leaving an electrophoretic variant that accounts for most of the residual CK activity. This variant, called CK-BB', migrates on electrophoresis similarly to creatine kinase isoenzyme MB. Using electrophoresis and immunoinhibition with antiserum to creatine kinase isoenzyme MM, we found CK-BB to be the only identifiable cytoplasmic isoenzyme in surgical samples from human brain and intestine. In contrast, we found that some samples of brain obtained at autopsy contain CK-BB'. We also found that CK-BB extracted from human brain was converted to CK-BB' upon incubation in serum or plasma at 37 degrees C. We found a similar development of CK-BB' in incubation mixtures of serum or plasma containing CK-BB obtained from surgical samples of human intestine. The development of CK-BB' during infarction of the gastrointestinal system may thus be a source of false-positive CK-MB in the laboratory verification of myocardial infarction when electrophoresis is used as the only method to identify CK isoenzymes.

Risk Stratification in Suspected Acute Myocardial Infarction Based on a Sensitive Immunoassay for Serum Creatine Kinase Isoenzyme MB

Cardiology ◽  
1992 ◽  
Vol 80 (2) ◽  
pp. 143-151 ◽  
Author(s):  
Jan Ravkilde ◽  
Annebirthe Bo Hansen ◽  
Mogens Hørder ◽  
Poul J. Jørgensen ◽  
Kristian Thygesen
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Risk Stratification ◽  
Serum Creatine Kinase ◽  
Creatine Kinase Isoenzyme ◽  
Suspected Acute Myocardial Infarction ◽  
Creatine Kinase Isoenzyme Mb
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