scholarly journals Application of the Regression Coefficient to Timed Serial Serum Creatine Kinase Measurements in the Early Diagnosis of Myocardial Infarction

Author(s):  
G Rutty ◽  
Shanta Patel ◽  
P O'Gorman
1993 ◽  
Vol 39 (3) ◽  
pp. 488-495 ◽  
Author(s):  
V Bhayana ◽  
S Cohoe ◽  
F Y Leung ◽  
G Jablonsky ◽  
A R Henderson

Abstract The diagnostic efficacy of creatine kinase (CK) isoforms (CK-3 and CK-2) was compared with measurement of CK-2 mass concentrations for the early diagnosis of myocardial infarction (MI). Serial serum samples drawn from 76 patients with confirmed MI and 55 non-MI patients were used for determining CK-2 mass concentrations and the MM3/MM1 (CK-3 isoforms) and MB2/MB1 (CK-2 isoforms) ratios. We compared the diagnostic utility of each by receiver-operating-characteristic (ROC) curve and likelihood ratio analyses. Our results indicate that all three tests were ineffective within the first 4 h after the onset of chest pain. All three were most effective at 4-18 h after onset, but both CK-3 and CK-2 isoform ratios were less effective than CK-2 mass concentrations in the next 6-h period (18-24 h). In the critical time between 3 and 6 h, the diagnostic performance of all three was comparable.


1994 ◽  
Vol 24 (5) ◽  
pp. 683
Author(s):  
Jae Gyeok Yoo ◽  
Chul Woo Kim ◽  
Tae Ho Song ◽  
Hyeon Dae Kim ◽  
Sung Yun Lee ◽  
...  

2021 ◽  
pp. 73-75
Author(s):  
Mallaiyan Manonmani ◽  
Meiyappan Kavitha

Objectives: Myocardial infarction is the most common form of coronary heart disease, the commonest cause of worldwide mortality. The present biochemical markers take atleast 6 hours for elevation following an episode of myocardial infarction. There is a need for sensitive marker for early diagnosis and prognosis. Lactate, the end product of anaerobic glycolysis is found to be elevated in many critical illnesses. Thus the study was undertaken to assess the levels of serum lactate in patients with myocardial infarction and to correlate it with the frequently used enzymatic markers for the diagnosis of myocardial infarction, i.e creatine kinase – MB and lactate dehydrogenase Methods: Fifty age and sex matched controls and fty cases of myocardial infarction were included in the study. Serum creatine kinase – MB, lactate dehydrogenase and lactate were estimated in these subjects. Results:The serum lactate levels were signicantly higher among cases when compared to controls. The serum lactate levels positively correlated with serum creatine kinase – MB among cases but not with lactate dehydrogenase. Conclusions: We conclude that serum lactate is altered in patients with myocardial infarction and may be considered as a prognostic risk factor in these patients. Further studies are needed to nd the cut-off value of serum lactate for assistance in the hemodynamic management of these patients.


1980 ◽  
Vol 26 (3) ◽  
pp. 457-462 ◽  
Author(s):  
J P Chapelle ◽  
C Heusghem

Abstract Serum creatine kinase (EC 2.1.3.2) isoenzyme MM was resolved by isoelectric focusing into a five-band pattern, a pattern that gradually changed after the onset of myocardial infarction. Similar changes were also demonstrated in patients undergoing coronary-bypass surgery. The evolution of two CK-MB sub-bands was studied in both cases. We found that three electrophoretic bands (CK-MM, pI 7.10; MM1, pI 6.88; MB1, pI 5.61) were predominant in patterns for sera collected during the early phase of myocardial infarction, but rapidly disappeared during the following hours, whereas bands of increased electrophoretic mobility (MM2, pI 6.70; MM3, pI 6.45; MM4, pI 6.25; MB2, pI 5.34) gradually increased. MM3 was always the major band at the end of the observation period in acute myocardial infarction (mean, 61.4% of total creatine kinase activity 36 h after the peak value for total creatine kinase in serum). The CK-MM bands were also present in the serum of patients without heart disease. Changes in the electrophoretic pattern were induced by a thermolabile factor in normal human serum, which transformed the muscular or myocardial MM and MM1 bands after their release into the blood stream.


1972 ◽  
Vol 18 (4) ◽  
pp. 330-334 ◽  
Author(s):  
Fram R Dalal ◽  
Jonathan Cilley ◽  
Seymour Winsten

Abstract Addition of sulfhydryl groups to the reaction mixture, to stabilize serum creatine kinase (creatine phosphokinase, CPK), results in apparent increases in the activity of this enzyme in many sera. In addition, in sera from patients just after myocardial infarction, assays for sulfhydryl-activated CPK have a different clinical pattern than do those for CPK assayed without sulfhydryl activators: activities are greater and remain abnormally high longer in assays in which the enzyme is sulfhydryl activated. If the assay is done without sulfhydryl activators present, technical difficulties appear, because CPK in serum is rapidly inactivated at room temperature. CPK is apparently inactivated in at least two ways. One, which is irreversible, is inhibited by albumin; the other, which is reversible by sulfhydryl groups, seems to result from the presence of substances in the pooled serum used that are both protein bound and free.


1990 ◽  
Vol 36 (5) ◽  
pp. 775-777 ◽  
Author(s):  
J Williams ◽  
K M Williams ◽  
T Marshall

Abstract We used isoelectric focusing (IEF) in polyacrylamide gels to investigate the effects of glutathione on the sub-bands of serum creatine kinase (CK; EC 2.7.3.2) isoenzyme MM in acute myocardial infarction. The intensity of the "abnormal" sub-bands c (pI 7.25), e (pI 6.85), and g (pI 6.50) increased, and that of the "normal" sub-bands 1 (pI 6.91), 2 (pI 6.65), and 3 (pI 6.35) decreased, following serum incubation with reduced glutathione (GSH, final concentration 1.25 mmol/L). Further incubation with oxidized glutathione (GSSG, final concentration 5 mmol/L) reversed this change and restored the original pattern, whereas GSSG at 7.5 mmol/L caused sub-bands c, e, and g to disappear and sub-bands 1, 2, and 3 to be enhanced. Sequential incubation of serum with 2.5 mmol of GSSG and 7.5 mmol of GSH per liter produced the opposite sequence of events; i.e., the "abnormal" sub-bands disappeared then reappeared (and GSH at 10 mmol/L enhanced their reappearance). At higher concentrations, glutathione (GSH or GSSG) impaired the detection of the CK-MM sub-bands after IEF, an effect that was "quenched" by heat-inactivated serum of low CK activity. Likewise, the intensity of tissue CK-MM (corresponding to myocardium extracted into 100 mmol/L Tris HCl buffer, pH 7.4) was greatly enhanced by adding heat-inactivated serum to the tissue extract before IEF. We discuss the significance of these findings for the diagnosis of myocardial infarction.


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