title: Postoperative elevation of creatine kinase (CK-MB): does it contribute to diagnosis of myocardial infarction?
abstract: OBJECTIVE
  This retrospective study sought to determine the benefit of measurement of changes in plasma creatine kinase-myocardial band (CK-MB) levels in elective postoperative high risk surgical patients beyond that obtained from the surface 12 lead ECG.
  
  
  METHODS
  The charts of 111 patients admitted to the surgical intensive care unit (SICU) of a tertiary level university teaching hospital were reviewed. They were screened using predetermined definitions of myocardial infarction (MI) (as reflected by changes in the 12 lead surface ECG (Minnesota code) or elevations in CK-MB) for complications such as pulmonary oedema, congestive heart failure, arrhythmias, or cardiogenic shock. Four groups were identified based on changes in the ECG indicative of MI (Present-ECG+ or Absent-ECG-) and elevations of CK-MB (Present-CKMB+ or Absent-CKMB-) and compared for the incidence of complications.
  
  
  RESULTS
  No patient with ECG- findings had a complication. Fifteen patients with ECG+ findings were identified and all had complications. Fourteen of these patients had CKMB+ results. In contrast, 29 patients with CKMB+ results alone (i.e., ECG-) had no complications.
  
  
  CONCLUSIONS
  Clinically important (i.e., requiring therapeutic intervention) postoperative myocardial infarction was detected by ECG changes. The benefit of determining changes in CK-MB was minimal from a therapeutic perspective.
authors.affiliation: Department of Anaesthesia, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Chedrawy
authors.forename: R
authors.initials: R
authors.lastname: Hall
authors.forename: V
authors.initials: V
authors.lastname: Nedelcu
mesh_terms: D000328:Adult; D000368:Aged; D003402:Creatine Kinase / Q000097:blood*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D011183:Postoperative Complications / Q000175:diagnosis*; D012189:Retrospective Studies
chemical_list: D007527:Isoenzymes; D003402:Creatine Kinase