title: Noninvasive detection of reperfusion in acute myocardial infarction based on plasma activity of creatine kinase MB subforms.
abstract: Successful thrombolytic therapy is associated with an accelerated release of creatine kinase (CK) MB from necrotic myocardium. With use of a previously validated assay, the plasma kinetics of the myocardial subform (MB2) and the plasma-modified subform (MB1) were determined in blood samples obtained from 56 patients with acute Q wave myocardial infarction: 33 patients who received thrombolytic therapy (group A) and 23 patients managed conservatively (group B). Plasma MB2 activity increased more rapidly in the group A patients, but there was substantial overlap with group B. Plasma MB1 activity did not differ significantly between the two groups. The MB2/MB1 ratio was significantly higher in group A patients than in group B patients between 2 and 10 h after the onset of infarction. Among group A patients, the ratio increased from 2.4 +/- 1.6 to 4.6 +/- 2.0 in the 1st h after therapy (p less than 0.001). The peak ratio was 6.3 +/- 2.5 in group A patients and 3.1 +/- 1.2 in group B patients. Twenty-seven of the 33 group A patients had a peak ratio greater than 3.8 versus 5 of the 23 group B patients (p less than 0.001). In seven group A patients, the ratio was greater than 3.8 before plasma CK MB activity was out of the normal range. Angiography was performed at 5.0 +/- 3.5 days in 39 patients. Eighteen (90%) of 20 patients with a patent infarct-related artery had a peak ratio greater than 3.8; 17 (89.5%) of 19 patients with an occluded infarct-related artery had a ratio less than 3.8 (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Molecular Cardiology Unit, Baylor College of Medicine, Houston, Texas.
authors.forename: P R
authors.initials: PR
authors.lastname: Puleo
authors.forename: M B
authors.initials: MB
authors.lastname: Perryman
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000378:metabolism*; D004562:Electrocardiography; D006801:Humans; D007527:Isoenzymes; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy* / Q000201:enzymology*; D015425:Myocardial Reperfusion; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014654:Vascular Patency
chemical_list: D007527:Isoenzymes; D003402:Creatine Kinase; D010959:Tissue Plasminogen Activator