Detection of reperfusion 30 and 60 minutes after coronary recanalization by a rapid new assay of creatine kinase isoforms in acute myocardial infarction.
We measured creatine kinase (CK) isoforms by a new immunoinhibition method to evaluate their usefulness in detecting early coronary reperfusion. Blood samples were collected at 15-minute intervals from 50 patients with acute myocardial infarction. CK isoforms were determined by a 10-minute immunoinhibition method with an autoanalyzer. Values for inhibited isoforms (MM3, MM2/2, and MB2/2) were divided by those of noninhibited isoforms (MM1, MM2/2, MB1, MB2/2, and BB) to calculate the isoform ratio. In the reperfused group the increase in the isoform ratio was 2.69 +/- 1.80 (SD) 30 minutes after reperfusion and 2.41 +/- 2.01 at 60 minutes, which was significantly higher than the corresponding values in the nonreperfused group (0.17 +/- 0.16 and 0.32 +/- 0.26, respectively). When an increase of 0.70 or more in the isoform ratio was used as the criterion for reperfusion, the sensitivity and specificity were 92% and 100% at 30 minutes and 100% and 100% at 60 minutes after recanalization, respectively. We conclude that the isoform ratio obtained by the new 10-minute assay of CK isoforms is useful for the noninvasive detection of reperfusion 30 and 60 minutes after recanalization in acute myocardial infarction.
Abe
S
S
First Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Japan.
Nomoto
K
K
Arima
S
S
Miyata
M
M
Yamashita
T
T
Maruyama
I
I
Toda
H
H
Okino
H
H
Atsuchi
Y
Y
Tahara
M
M
D015906:Angioplasty, Balloon, Coronary; D001322:Autoanalysis; D004796:Clinical Enzyme Tests / Q000379:methods*; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy; D015425:Myocardial Reperfusion; D011994:Recombinant Proteins / Q000627:therapeutic use; D012680:Sensitivity and Specificity; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
D007527:Isoenzymes; D011994:Recombinant Proteins; D003402:Creatine Kinase; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator; C067551:saruplase