Prevention of creatine kinase-MB release in coronary artery disease and pacing-induced myocardial ischemia by isosorbide dinitrate spray.
The effect of isosorbide dinitrate (ISDN) spray on release of the isoenzyme creatine kinase-MB (CK-MB) after myocardial ischemia induced by atrial pacing was evaluated in 8 patients with coronary artery disease. Atrial pacing to ischemia (ST-segment depression of greater than or equal to 1.5 mm for greater than or equal to 80 ms) resulted in elevation of CK-MB levels in plasma drawn from the coronary sinus, from 1.8 +/- 1.5 to 6.8 +/- 7.0 ng/ml (p less than 0.001) at 30 minutes after onset of ischemia. When atrial pacing was repeated at the same rate after 1 squirt of ISDN spray, 1.25 mg, the CK-MB levels were not altered despite significant ischemic ST-segment depression. It is concluded that ISDN prevents the process responsible for myocardial release of CK-MB, being either micronecroses or a reversible consequence of ischemia.
Marmor
A
A
Cardiology Department, Rebecca Sieff Medical Center, Safed, Israel.
Klein
R
R
D000284:Administration, Oral; D000336:Aerosols; D002304:Cardiac Pacing, Artificial; D003327:Coronary Disease / Q000188:drug therapy*; D003402:Creatine Kinase / Q000378:metabolism*; D006801:Humans; D007527:Isoenzymes; D007548:Isosorbide Dinitrate / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism
D000336:Aerosols; D007527:Isoenzymes; D003402:Creatine Kinase; D007548:Isosorbide Dinitrate