Peak CKMB and cTnT accurately estimates myocardial infarct size after reperfusion.
OBJECTIVE
To find the time-to-peak for creatine kinase MB(mass) (CKMB) and cardiac troponin T (cTnT) after acute reperfusion, to compare peak and cumulative values to estimate infarct size (IS), and to evaluate clinical routine sampling for assessment of IS.


METHODS
Acute primary percutaneous coronary intervention (PCI) was performed in 38 patients with first-time myocardial infarction. In 21 patients, CKMB and cTnT were acquired before PCI and at 1.5, 3, 6, 12, 18, 24, and 48 hours thereafter. In 17 patients, clinical routine samples were acquired at arrival, and at 10 and 20 h. IS was assessed by delayed contrast-enhanced MRI (DE-MRI).


RESULTS
Time-to-peak was 7.6+/-3.6 h for CKMB and 8.1+/-3.4 h for cTnT. Peak values correlated strongly to cumulative values (r(s)=0.97-0.98) as well as to DE-MRI (r(s)=0.8-0.82). Clinical routine sampling showed lower rs values (0.47-0.60).


CONCLUSIONS
Peak values are likely captured if CKMB and cTnT are acquired at 3, 6, and 12 h after acute PCI. These peak values can be used to estimate myocardial infarct size after acute PCI.
Hedström
Erik
E
Department of Clinical Physiology, Lund University, Lund, Sweden.
Aström-Olsson
Karin
K
Ohlin
Hans
H
Frogner
Fredrik
F
Carlsson
Marcus
M
Billgren
Therese
T
Jovinge
Stefan
S
Cain
Peter
P
Wagner
Galen S
GS
Arheden
Håkan
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D023921:Coronary Stenosis / Q000097:blood / Q000150:complications* / Q000628:therapy; D052279:Creatine Kinase, MB Form / Q000097:blood*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000209:etiology / Q000473:pathology / Q000628:therapy; D015425:Myocardial Reperfusion; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012107:Research Design; D015607:Stents; D013997:Time Factors; D020107:Troponin T / Q000097:blood*
D015415:Biomarkers; D020107:Troponin T; D052279:Creatine Kinase, MB Form