title: Clinical assessment of infarct size by serial determinations of serum creatine phosphokinase activity.
abstract: Infarct size (IS) was estimated from serial total creatine phosphokinase (CK) changes in 82 patients with acute myocardial infarction (MI). Anteroseptal and inferior MI involved a relatively small mass of myocardium (16.0 +/- 6.4 and 24.7 +/- 10.0 CK-g-eq respectively); anteroapical and inferoposterior MI had an average IS of 35.9 +/- 15.9 and 32.8 +/- 13.8 CK-g-eq respectively (NS); extensive anterior and inferoposterolateral MI had an average IS of 57.8 +/- 20.1 and 51.1 +/- 11.5 CK-g-eq respectively (NS). Left ventricular failure (LVF) correlated with estimated IS and not with location of the infarct. In patients with an IS ranging from 30 to 50 CK-g-eq, the incidence of LVF was 33%. In patients with an IS greater than 50 CK-g-eq, the incidence of LVF was 65%. Out of the 6 patients who died, 3 had an IS greater than 60 CK-g-eq. 3 groups of patients could be identified from the duration of the CK release time: in group I (mean = 20 +/l h; n = 61), infarct size was highly correlated with peak CK activity (r = 0.93); in group II (mean = 39 +/- 7 h; n = 17) the correlation between IS and peak CK activity was poor (r = 0.59) and might indicate a gradual necrosis; in group III (n = 4) patients with reinfarction showed a second peak on the descending limb of the CK activity curve. Follow-up information was available in 96% of the 76 survivors. At the end of the follow-up (18.1 +/- 10.8 mth) IS was not significantly different in patients with LVF (42.7 +/- 17.5 CK-g-eq) and in those without LVF (34.7 +/- 19.7 CK-g-eq).
mesh_terms: D000328:Adult; D000368:Aged; D003402:Creatine Kinase / Q000097:blood*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000201:enzymology / Q000401:mortality; D011379:Prognosis; D013223:Statistics as Topic; D013997:Time Factors
chemical_list: D003402:Creatine Kinase