Vnitr Lek 1997, 43(11):715-721

[Levels of CK MB mass in patients with acute myocardial infarct treatedwith fibrinolysis. Comparison with levels of CK, CKMB, CKMB mass and troponin T in the diagnosis of coronary ischemia].

J Bastecký, J Vávrová, V Palicka, E Ettlerová, V Wasyliwová, V Rehácek

I. interní klinika FN, Hradec Králové.

In a group of 26 patients with AIM the CKMB value was raised above the discrimination level already on admission--on average 2.7 +/- 1.4 hours after development of ischaemic pain--in 46% patients. The maximal value of CKMB mass was achieved in the group with probable reperfusion 12.1 +/- 3.8 hours after the development of ischaemic pain and this value was elevated in relation to the discrimination value 41.5 +/- 17x and in relation to the so-called basal value 145 +/- 117x. In the group without probable reperfusion the maximal value was achieved significantly later, after 19.8 +/- hours and was elevated in relation to the discrimination value 31 +/- 17x and in relation to the final value 84 +/- 42 times. The value of CKMB mass increased above the discrimination limit from the onset of ischaemic pain after 4.0 +/- 1.5 and after 5.7 +/- 3 hours in the group with probable and without probable reperfusion and declined below the discrimination limit after 00 +/- 60 and 119 +/- 98.0 hours in the same groups. On comparison of CK, CKBM, CKBM mass and troponin T on admission the CKMB mass value was elevated in 46% patients, the value of CK in 23%, of CKMB in 27% and the troponin T value in 96% patients. With regard to the assembled experience that haemolytic serum raises false troponin T values, the percentage of elevated troponin T values on admission declines from the original 96% to 81% when all haemolytic samples are eliminated. The time of reaching maximal values of CKMB mass in patients with AIM and probable reperfusion was significantly shorter than in CK values and is similar as in CKMB values. The time taken to raise the CKBMB mass value above the discrimination value is significantly shorter than the time taken by CK levels, but significantly longer than the time before troponin T levels are raised. The time of total elevation of CKMB mass levels above the discrimination limit does not differ from the time taken to raise CK values, it is however shorter than the increase of troponin T values, although the exact time of persistence of raised levels of troponin T was not assessed in our work. The time of increase above and decrease below the discrimination limit was not assessed in CKMB values. Based on mutual comparison of the impact of indicators for assessment of the diagnosis of ischaemic heart attacks the authors consider it best regardless of financial costs--to assess troponin T, possibly along with levels of CKMB mass.

Keywords: Biomarkers, blood, ; Creatine Kinase, blood, ; Female; Humans; Isoenzymes; Male; Middle Aged; Myocardial Infarction, diagnosis, ; Myocardial Reperfusion Injury, diagnosis, ; Thrombolytic Therapy; Troponin, blood, ; Troponin T

Published: November 1, 1997  Show citation