title: Predictive value of creatine kinase (CK)-MB for diagnosis of acute myocardial infarction after major noncardiac surgery.
abstract: 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.
authors.affiliation: Section of Clinical Epidemiology, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: F
authors.initials: F
authors.lastname: López-Jiménez
authors.forename: L
authors.initials: L
authors.lastname: Goldman
authors.forename: E J
authors.initials: EJ
authors.lastname: Thomas
authors.forename: K M
authors.initials: KM
authors.lastname: Kuntz
authors.forename: D B
authors.initials: DB
authors.lastname: Sacks
authors.forename: T H
authors.initials: TH
authors.lastname: Lee
mesh_terms: 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
chemical_list: D007527:Isoenzymes; D003402:Creatine Kinase