Creatine kinase (CK): its use in the evaluation of perioperative myocardial infarction.
Establishing the diagnosis of acute perioperative myocardial infarction by the mere presence of a serum CK-MB band alone is not valid. Laboratory investigations have shown that tissues other than ventricular myocardium hold appreciable quantities of CK-MB. Moreover, each of the laboratory methods commonly used for measuring serum total CK and its isoenzymes have inherent strengths and weaknesses. Hence, accurate evaluation of perioperative CK-MB bands requires determination of the amplitude and the temporal course of the elevation. Confirmation of the CK-MB findings by analysis of another enzyme system is advisable. Serum lactate dehydrogenase isoenzymes can fulfill this role. Institution of a dual enzyme evaluation is achieved easily in most hospitals and can yield a very high degree of sensitivity and specificity. The final step in diagnostic accuracy is completed by continuing evaluation of the enzyme diagnostic system in each individual institution.
D006348:Cardiac Surgical Procedures; D002845:Chromatography; D003402:Creatine Kinase / Q000032:analysis / Q000097:blood*; D004064:Digestive System / Q000201:enzymology; D004586:Electrophoresis; D006801:Humans; D007527:Isoenzymes; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007813:Laparotomy; D009132:Muscles / Q000201:enzymology; D009203:Myocardial Infarction / Q000175:diagnosis*; D009206:Myocardium / Q000201:enzymology; D011184:Postoperative Period; D011300:Preoperative Care; D011863:Radioimmunoassay; D013903:Thoracic Surgery; D013997:Time Factors
D007527:Isoenzymes; D007770:L-Lactate Dehydrogenase; D003402:Creatine Kinase