Predictive value of creatine kinase (CK)-MB for diagnosis of acute myocardial infarction after major noncardiac surgery.
BACKGROUND
The aim of this study was to provide insight into the interpretation of CK-MB data after major noncardiac surgery.


METHODS
Some 3,321 patients who underwent major non-emergent noncardiac procedures (orthopedic 31%, intrathoracic 12%, vascular 22%, other 35%) were studied. All patients had at least two CK samples measured postoperatively.


RESULTS
Acute myocardial infarction was diagnosed in 43 (1.3%) patients using study criteria including CK-MB and electrocardiographic data. All of the various threshold values of peak CK-MB values and peak CK-MB as a percentage of total CK had poor positive predictive values because of high false positive rates and the low rate of acute myocardial infarction.


CONCLUSIONS
These data demonstrate the need for markers of myocardial injury with greater cardiac specificity after noncardiac surgery.
López-Jiménez
F
F
Section of Clinical Epidemiology, Brigham and Women's Hospital, Boston, MA, USA.
Goldman
L
L
Thomas
E J
EJ
Kuntz
K M
KM
Sacks
D B
DB
Lee
T H
TH
D000368:Aged; D003402:Creatine Kinase / Q000378:metabolism*; D005260:Female; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000201:enzymology; D011183:Postoperative Complications / Q000175:diagnosis* / Q000201:enzymology; D011237:Predictive Value of Tests; D012189:Retrospective Studies
D007527:Isoenzymes; D003402:Creatine Kinase