Clinical and angiographic correlates of normal creatine kinase with increased MB isoenzymes in possible acute myocardial infarction.
A retrospective study of patients with possible acute myocardial infarction was conducted over a 2-year period to evaluate the clinical characteristics, angiographic findings, and in-hospital prognosis in patients with normal total creatine kinase (CK) activity and increased MB isoenzyme activity (CK-MB). Thirty-nine cases were identified (study group) and compared with cases of Q-wave (n = 77) and non-Q-wave (n = 60) infarctions. Compared with the Q-wave group, study group patients were older (67.5 +/- 9.0 vs 60.8 +/- 11.5 years; p < 0.01) and more often had previous diagnoses of coronary disease (52.6% vs 18.2%; p < 0.01) and peripheral vascular disease (28.9% vs 10.4%; p = 0.02). Angina (92.2% vs 65.8%; p < 0.01) and ST elevation (81.8% vs 13.2%; p < 0.01) were more common in the Q-wave group. Nearly identical clinical profiles and electrocardiographic findings were observed in the study and non-Q-wave groups. Angiographic analysis revealed a higher frequency of multivessel disease in the study group (89.6%) than in the Q-wave group (48.6%, p < 0.01) but no difference between the study group and the non-Q-wave group (79.6%; p not statistically significant). Left ventricular function and in-hospital complications were similar among groups. It is concluded that patients with normal total CK activity and increased CK-MB concentration represent a subgroup of patients with non-Q-wave infarction with a high prevalence of multivessel coronary disease.
Dorogy
M E
ME
Department of Medicine, Fitzsimons Army Medical Center, Aurora, Colo., USA.
Hooks
G S
GS
Cameron
R W
RW
Davis
R C
RC
D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D016277:Ventricular Function, Left
D007527:Isoenzymes; D003402:Creatine Kinase