Creatine kinase MB isoforms: sensitive markers of ischemic myocardial damage.
We investigated the use of creatine kinase (CK) MB isoforms as a marker of myocardial cell injury in a preliminary study of 16 patients with chronic stable angina after successful percutaneous transluminal coronary angioplasty (PTCA) and 25 patients after coronary artery bypass grafting (CABG). Three control groups were studied: apparently healthy volunteers (n = 31), patients undergoing thoracotomy (n = 10), and patients undergoing routine coronary angiography (n = 9). Patients in the PTCA group showed an association between ischemic ST segment changes lasting > 3 min and a transient increase in the MB2/MB1 ratio; however, all had total CK-MB activity within normal limits. Routine coronary angiography subjects had no significant change in MB2/MB1. In the CABG patients, MB2/MB1 peaked within 1 h after the cross-clamp release and returned to baseline by 24 h postoperatively. The median time to peak MM3/MM1 and total CK-MB activity was 2 and 8 h after reperfusion, respectively, returning to baseline values by 2 and 5 days, respectively. After thoracotomy, MB2/MB1 was increased only in elderly patients (n = 5) with risk factors for ischemic heart disease; total CK-MB activity was increased in only three of these. Apparently, CK-MB isoforms can detect myocardial damage in clinical settings with less overt damage than myocardial infarction.
Hossein-Nia
M
M
Analytical Unit, St. George's Hospital Medical School, London, UK.
Kallis
P
P
Brown
P A
PA
Chester
M R
MR
Kaski
J C
JC
Murday
A J
AJ
Treasure
T
T
Holt
D W
DW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000201:enzymology / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006801:Humans; D007527:Isoenzymes; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000201:enzymology*; D013908:Thoracotomy
D007527:Isoenzymes; D003402:Creatine Kinase