scholarly journals Kreatinkinazės MB frakcijos reikšmė perioperacinio miokardo infarkto diagnostikoje

2007 ◽  
Vol 5 (3) ◽  
pp. 0-0
Author(s):  
Gediminas Kitra ◽  
Gediminas Kundrotas ◽  
Vilija Jakumaitė
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Myocardial Injury ◽  
Postoperative Morbidity ◽  
Heart Surgery ◽  
Diagnostic Value ◽  
Perioperative Myocardial Infarction ◽  
Hospital Department ◽  
Routine Measurement ◽  
Creatine Kinase Mb

Gediminas Kitra1, Gediminas Kundrotas1, Vilija Jakumaitė1,21 Klaipėdos jūrininkų ligoninės Kardiochirurgijos skyrius,Liepojos g. 45, LT-92288 Klaipėda2 Kauno medicinos universiteto Psichofiziologijos ir reabilitacijos institutas,Vydūno al. 4, LT-00135 PalangaEl paštas: [email protected] Įvadas / tikslas Perioperacinis miokardo infarktas (PMI) po širdies operacijos didina pooperacinį sergamumą ir mirštamumą. Iki šiol nėra vienodų kriterijų PMI po aortos vainikinių jungčių operacijos diagnozuoti. Šio darbo tikslas – įvertinti kreatinkinazės MB frakcijos diagnostinę reikšmę. Ligoniai ir metodai Tirti 706 ligoniai, kuriems nuo 2004 m. sausio 2 d. iki 2007 m. vasario 22 d. buvo darytos aortos vainikinių jungčių operacijos naudojant dirbtinę kraujo apytaką (DKA). 69 (10%) ligoniams, remiantis elektrokardiograma ir kreatinkinazės MB koncentracijos padidėjimu, diagnozuotas PMI, 101 (14%) ligoniui nustatytas kreatinkinazės padidėjimas nesiekė diagnostinės ribos, jų miokardo pažeidimas vertintas kaip galimas perioperacinis miokardo pažeidimas. Rezultatai Ligoniams, kuriems yra PMI ir galimas PMI, pooperacinė eiga dažniau komplikavosi ūminiu širdies nepakankamumu. Šiose grupėse buvo didesnis hospitalinis mirštamumas, tačiau ligonių, kuriems buvo galimas PMI, mirštamumas dėl kardialinių priežasčių buvo mažesnis ir nesiskyrė nuo ligonių, kuriems miokardas nebuvo pažeistas. Išvados Rutininis kreatinkinazės MB frakcijos tyrimas po aortos vainikinių jungčių operacijos padeda diagnozuoti PMI ir prognozuoti tolesnę pooperacinę eigą. Kreatinkinazės MB frakcijos (CKMB) padidėjimas >100 u/l lemia didesnį hospitalinį mirštamumą. CKMB padidėjimas <100 u/l hospitaliniam mirštamumui įtakos neturi, tačiau lemia dažnesnį širdies nepakankamumą. Pagrindiniai žodžiai: perioperacinis miokardo infarktas, kreatinkinazės MB frakcija Significance of creatine kinase MB for the detection of perioperative myocardial infarction Gediminas Kitra1, Gediminas Kundrotas1, Vilija Jakumaitė1,21 Klaipėda Seamen’s Hospital, Department of Cardiosurgery,Liepojos str. 45, LT-92288 Klaipėda, Lithuania2 Institute of Psychophysiology and Rehabilitation, Kaunas University of Medicine,Vydūno ave. 4, LT-00135 Palanga, LithuaniaE-mail: [email protected] Background / objective Perioperative myocardial infarction (PMI) after heart surgery increases postoperative morbidity and mortality. Until now there are no universal criteria to confirm the diagnosis of PMI. We analysed the diagnostic value of creatine kinase MB fraction. Patients and methods 706 patients who underwent CABG with CPB from January 2, 2004 until February 22, 2007 were analyzed. 69 (10%) sustained PMI. The diagnosis was based on electrocardiogram and CKMB elevation. 101 (14%) were considered to have probable PMI, because their CKMB didn’t reach the diagnostic value. Results The postoperative course was complicated by acute heart failure more frequently in those with PMI and probable PMI. Hospital mortality was also higher in these patients. However, mortality from cardiac courses was lower in the group with probable PMI and similar to that in patients without perioperative myocardial injury. Conclusions Routine measurement of CKMB after CABG is of great importance in diagnosing PMI and predicts the clinical outcome. Key words: perioperative myocardial infarction, creatine kinase MB fraction

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

2004 ◽  
Vol 128 (2) ◽  
pp. 158-164 ◽  
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.

Troponin T as a Marker of Infarction during Coronary Bypass Surgery

2000 ◽  
Vol 8 (1) ◽  
pp. 19-23
Author(s):  
Tarek A Abdel Aziz ◽  
Mohamed A Ali ◽  
Donald G Roberts ◽  
Najib Al Khaja
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Troponin T ◽  
Artery Bypass ◽  
Myocardial Damage ◽  
Perioperative Myocardial Infarction ◽  
Creatine Kinase Mb ◽  
Group A ◽  
Electrocardiographic Changes ◽  
Group B

To evaluate serum troponin T as a marker of perioperative myocardial infarction, 50 patients undergoing coronary artery bypass grafting were divided into 2 groups. Group A (14 patients) had serum creatine kinase MB-isoenzyme levels above 100 U·L−1 and electrocardiographic changes indicative of infarction. Group B (36 patients) had creatine kinase MB levels below 100 U·L−1 and no electrocardiographic changes. Blood samples were obtained preoperatively, 6 hours after aortic declamping, and on postoperative day 1, 2, and 3. Following surgery, all patients had increased levels of troponin T and creatine kinase MB. Troponin T was significantly higher in group A compared to group B at 6 hours, day 1, and day 2 postoperatively. Creatine kinase MB levels were significantly higher in group A compared to group B at 6 hours and day 1 postoperatively. The increased levels of troponin T in patients without myocardial infarction suggest that some operative myocardial damage occurred. Patients with perioperative myocardial infarction had significantly higher levels of troponin T up to postoperative day 2, whereas creatine kinase MB levels were almost normal by day 2. This suggests that troponin T may be used up to 2 days postoperatively for detection of myocardial infarction.

Mass concentration of creatine kinase MB isoenzyme and lactate dehydrogenase isoenzyme 1 in diagnosis of perioperative myocardial infarction after coronary bypass surgery

1990 ◽  
Vol 36 (10) ◽  
pp. 1784-1788 ◽  
Author(s):  
B Gulbis ◽  
P Unger ◽  
A Lenaers ◽  
J M Desmet ◽  
H A Ooms
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Lactate Dehydrogenase ◽  
Mass Concentration ◽  
Bypass Surgery ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Perioperative Myocardial Infarction ◽  
Dehydrogenase Isoenzyme ◽  
Creatine Kinase Mb

Abstract Recent advances in methodology allow the mass concentration of creatine kinase MB isoenzyme (CK-MB), and of lactate dehydrogenase isoenzyme 1 (LD1) to be determined quickly and easily as routine, emergency tests. We evaluated these tests as diagnostic criteria of perioperative myocardial infarction (PMI) after coronary bypass surgery. These tests were compared with the usual measurements of CK-MB activity by immunoinhibition and LD1 by electrophoresis and with other biological markers of myocardial infarction such as total CK, total LD, and aspartate aminotransferase. Sixty-one patients who underwent coronary bypass grafting were followed pre- and postoperatively by enzyme determinations and electrocardiography; a subgroup was monitored by myocardial scintigraphy. CK-MB mass appeared to be the best marker of PMI during the first 48 h, although LD1 was the marker of choice from days 2 to 4.

scholarly journals Evaluating the use of biomarkers for the diagnosis of myocardial injury in neonates

2021 ◽  
pp. 15-20
Author(s):  
Nikhila Butani ◽  
Tapas Mondal
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Sensitivity And Specificity ◽  
Myocardial Injury ◽  
Diagnostic Tools ◽  
Diagnostic Strategies ◽  
Creatine Kinase Mb ◽  
Cardiac Troponins

Myocardial infarction is defined as the obstruction of blood flow to the heart, resulting in oxygen deprivation. While myocardial infarction in adults is common and has sufficient diagnostic strategies, there remain gaps in the diagnostic strategies for myocardial infarction in neonates. Presently, biomarkers such as creatine-kinase MB, brain natriuretic peptide, myoglobin, and troponin are believed to be potential diagnostic tools for neonatal myocardial infarction. This literature review explores the efficacy of biomarkers for early diagnosis of neonatal myocardial infarction. The review concludes that creatine-kinase MB, brain natriuretic peptide, and myoglobin do not serve as accurate biomarkers for myocardial infarction in neonates. However, cardiac troponins, in particular cardiac troponin I, have high sensitivity and specificity for diagnosing myocardial injury. Cardiac troponins experience rapid elevation upon myocardial injury, and they remain unaffected by gestational age and birth weight. In addition, they do not cross the placenta and are therefore intrinsic to the neonate. Future research should be conducted to verify the accuracy, sensitivity, and specificity of cardiac troponins as myocardial infarction biomarkers.  

ASSOCIATION OF SERUM LACTATE LEVELS WITH CREATINE KINASE – MB AND LACTATE DEHYDROGENASE IN PATIENTS WITH MYOCARDIAL INFARCTION

2021 ◽  
pp. 73-75
Author(s):  
Mallaiyan Manonmani ◽  
Meiyappan Kavitha
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Lactate Dehydrogenase ◽  
Serum Lactate ◽  
Serum Creatine Kinase ◽  
Hemodynamic Management ◽  
Diagnosis And Prognosis ◽  
Creatine Kinase Mb ◽  
Enzymatic Markers ◽  
Lactate Levels

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.

Improved column method for separating lactate dehydrogenase isoenzymes 1 and 2.

1978 ◽  
Vol 24 (3) ◽  
pp. 480-482 ◽  
Author(s):  
D W Mercer
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Heart Disease ◽  
Lactate Dehydrogenase ◽  
Sodium Chloride ◽  
Lactate Dehydrogenase Activity ◽  
Column Method ◽  
Creatine Kinase Mb ◽  
Lactate Dehydrogenase Isoenzymes

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.

scholarly journals Cardioprotective Potential of Ethanol Extract of Sonchus Arvensis L. Leaves on Isoproterenol-Induced Myocardial Infarction in Rat

2018 ◽  
Vol 16 (1) ◽  
pp. 20
Author(s):  
Neng Fisheri Kurniati ◽  
Elin Yulinah Sukandar ◽  
Rian Pardilah ◽  
Nova Suliska ◽  
Dhyan Kusuma Ayuningtyas
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Ethanol Extract ◽  
Wistar Rat ◽  
Positive Control ◽  
Negative Control ◽  
Albino Rats ◽  
Creatine Kinase Mb ◽  
Wistar Albino Rats ◽  
Sonchus Arvensis

Sonchus arvensis L. leaves have been used traditionally to treat various disease conditions. This study is designed to evaluate cardioprotective potential of ethanol extract of S. arvensis leaves on isoproterenol-induced myocardial infarction in Wistar rat. Male Wistar albino rats were divided into three main groups: negative control (saline only), positive control (isoproterenol only), and S. arvensis extract treated groups. S. arvensis extract was administered in three doses; 50, 100, and 200 mg/kg b.w. p.o for 14 days. On day 13 and 14, isoproterenol (85 mg/kg bw) was given intraperitoneally to positive control and extract treated groups. The parameters studied were cardiac biomarker enzymes which were Creatine Kinase (CK), Creatine Kinase-MB (CK-MB), Aspartate Transaminase (AST), Alanine Transaminase (ALT) and Lactate Dehydrogenase (LDH). The results showed that S. arvensis at dose of 50 mg/kg b.w. could significantly (P<0.05) reduce the level of CK, CK-MB, AST, ALT, and LDH in myocardial infarcted rats compared to positive control. The increase of the dose of S. arvensis extract was not followed by an increase of its cardioprotective activity. In conclusion, Sonchus arvensis L. leaves extract at dose of 50 mg/kg b.w. has potential to be developed as cardioprotective drug.

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