[Isoforms of creatine kinase and myoglobin in myocardial infarct treated by thrombolysis].
The isoforms of creatinine kinase (CK) and myoglobin were analysed by serial samplings in 45 patients admitted consecutively for myocardial infarction treated by thrombolysis according to the usual indications. Angiographic controls were carried out systematically in the first 24 hours, including 20 cases at the end of thrombolysis. The patients were divided into two groups according to the patency of the infarct related artery: Group I (n = 35) with a patent vessel and Group II (n = 10) with an occluded vessel; 4 patients in Group II were successfully revascularised by angioplasty. The total CK had a higher peak value in Group II (2,393 +/- 1,991 UI/l at 547 +/- 247 min versus 2,888 +/- 2,189 IU/l at 584 +/- 395 min) but the difference was not statistically significant. The analysis of CK isoforms showed the MM3/MM1 ratio to be higher at the 2nd hour in Group I (3.74 +/- 2.37 versus 3.09 +/- 1.43) with a faster increase, without attaining statistical significance. A fourth CK MM fraction was observed at the 2nd hour in 71% of patients in Group I compared with only 20% of patients in Group II. Analysis of myoglobin showed a significantly earlier peak value in Group I (1,218 +/- 1,117 micrograms/l at 133 +/- 62 min versus 1,309 +/- 1,549 micrograms/l at 210 +/- 84 min). The sensitivity and specificity of these different markers were respectively 40%, 86%, 77%, and 60%, 70% and 67% for the CK (peak before 8 hours), the MM3/MM1 ratio (increase of over 35% in the first hour) and myoglobin (peak before 2 hours).(ABSTRACT TRUNCATED AT 250 WORDS)
Béard
T
T
Service de cardiologie, hôpital Purpan, Toulouse.
Carrié
D
D
Stébenet
M
M
Delay
M
M
Jaillais
P
P
Thouvenot
J P
JP
Bernadet
P
P
D000790:Angiocardiography; D003402:Creatine Kinase / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000201:enzymology* / Q000378:metabolism / Q000628:therapy; D009204:Myocardial Revascularization; D009211:Myoglobin / Q000032:analysis*; D015912:Thrombolytic Therapy
D009211:Myoglobin; D003402:Creatine Kinase
Etude des isoformes de la créatine kinase et de la myoglobine dans l'infarctus du myocarde traité par thrombolyse.