[Maximal values of serum creatine phosphokinase and its myocardial fraction in acute myocardial infarct. Correlation with a previous history of ischemic cardiopathy].
OBJECTIVE
To evaluate the importance of preinfarction angina as a determinant of infarct size.


METHODS
Retrospective study of patients (pts) with acute myocardial infarction (AMI).


METHODS
Patients admitted to an Intensive Care Unit of a University Hospital.


METHODS
The study concerns 224 pts, 161 men women, aged 63.09 +/- 11.92 years, who did not receive thrombolytic or intravenous beta-blocking therapy and in whom it was possible to establish the presence or absence, of previous ischemic heart disease.


METHODS
Patients, were divided in 2 groups: A (1st AMI, 172 dts - 123 M, 49 F) and B (2nd AMI, 52 dts - 38 M, 14 F). These groups were subdivided according the presence of preinfarction angina (A1, B1) or its absence (A2, B2). The infarct size was evaluated by peak values of CK/CKMB.


RESULTS
Group A: CK/CKMB--959/101; Group B: CK/CKMB--742/77 (p-NS). Subgroups--A1: CK/CKMB--1143/118; A2: CK/CKMB--725/78 (p less than 0.001); B1: CK/CKMB--635/59; B2: CK/CKMB--818/88 (p-NS). The analysis of CK/CKMB values distribution, according to the affected cardiac wall, has shown an identical correlation.


CONCLUSIONS
1--The larger infarct size in subgroup A1 (1st AMI without angina) suggests a protective effect by collateral circulation in subgroup A2 (1st AMI with angina). 2--The larger infarction (although not significantly) in group A (1st AMI), correlates with less viable muscle in group B (2nd AMI). 3--The higher values of CK/CKMB in group B2 (2nd AMI with angina) can be expected given the presence of residual ischemia. 4--The absence of the protective role by collateral circulation in patients of subgroup A1 (1st AMI without angina) suggests for them a stronger indication for thrombolytic therapy.
Carvalho
M
M
Serviço de Medicina IV, Hospital de Santa Maria.
Brito
D
D
de Lacerda
A P
AP
Madeira
H
H
D000368:Aged; D000787:Angina Pectoris / Q000201:enzymology*; D000789:Angina, Unstable / Q000097:blood / Q000201:enzymology*; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000201:enzymology*; D012008:Recurrence; D012189:Retrospective Studies
D007527:Isoenzymes; D003402:Creatine Kinase
Valores máximos de creatinafosfoquinase sérica e sua fracção miocárdica no enfarte agudo do miocárdio. Correlação com história prévia de cardiopatia isquémica.