A comparison of serum isoenzyme levels of creatine phosphokinase and lactic dehydrogenase in patients undergoing thoracic operations and patients admitted to a coronary care unit.
A prospective study comparing patients undergoing major thoracic surgical procedures with patients admitted to a coronary care unit was conducted. Surgical patients having bronchoscopy and mediastinoscopy (n = 12), anterior thoracotomy (n = 12), and posterolateral thoracotomy (n = 22) were compared with patients in the coronary care unit who had electrocardiographically proved myocardial infarctions (MI) (n = 11) and those with no electrocardiographic abnormalities (n = 12). Sera were studied by spectrophotometric analysis (creatine phosphokinase [CPK] and lactic dehydrogenase [LDH]), agarose gel electrophoresis (CPK and LDH), and antibody inhibition spectrophotometric analysis (CPK). The levels of total CPK did not rise above the upper limits of normal (100 IU/L) in patients who underwent bronchoscopy and mediastinoscopy. Total CPK elevations in patients undergoing thoracotomy (anterior thoracotomy, 428 +/- 62 IU/L [mean +/- standard error of the mean]; posterolateral thoracotomy, 652 +/- 78 IU/L) were not significantly different from those sustaining acute MIs (463 +/- 84 IU/L). Only transient minimal elevations of CPK-MB isoenzyme were noted, however, in the patients having posterolateral thoracotomy (25 +/- 7 IU/L). These were significantly lower (p < 0.001) than the elevations seen in patients sustaining acute MIs (80 +/- 16 IU/L). In none of the surgical patients did LDH1 exceed LDH2 while all of the patients with MIs had such a shift (p < 0.001). The data support the conclusion that the serum isoenzymes of CPK and LDH are capable of confirming the diagnosis of MI in patients recovering from major thoracic surgical procedures.
D000328:Adult; D000368:Aged; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006801:Humans; D007527:Isoenzymes; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000201:enzymology*; D011446:Prospective Studies; D013903:Thoracic Surgery
D007527:Isoenzymes; D007770:L-Lactate Dehydrogenase; D003402:Creatine Kinase