title: Comparison of MB fraction of creatine kinase mass and troponin I serum levels with necropsy findings in acute myocardial infarction.
abstract: Serum levels of troponin and heart-related fraction of creatine kinase (CK-MB) mass are used as diagnostic and prognostic criteria in myocardial infarction, but the relation between those levels and the necropsy-determined size of necrosis has not been tested in human beings. In this retrospective study, 1-cm-thick transverse sections of the ventricles were cut from the base to the apex in the necropsy hearts of 27 patients aged 47 to 86 years (mean 66, median 69; 19 men). Total and necrotic areas were measured using a computer-linked image analysis system. The weights of the necrotic areas were also calculated. The correlations of the areas and weights of necrotic myocardium with the highest serum values of CK-MB mass and troponin I, which had been quantified during life by chemiluminescence immunoassays, were verified by Pearson's test; results were considered significant at p<or=0.05. Significant correlations were detected between CK-MB mass peak and infarct size (r=0.63, p<0.01) and weight (r=0.69, p<0.01) and between CK-MB mass and highest troponin level (r=0.73, p<0.01); however, the correlations between highest troponin level and myocardial infarct size (r=0.31, p=0.11) and weight (r=0.35, p=0.07) were small and nonsignificant. In conclusion, despite the well-established role of serum levels of troponin as a diagnostic tool for myocardial infarction, their highest values showed poor correlations with the extent of infarct. In contrast, the highest serum level of CK-MB mass was well correlated with myocardial infarct size.
authors.affiliation: Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Thiago Nogueira
authors.initials: TN
authors.lastname: Costa
authors.forename: Célia Maria
authors.initials: CM
authors.lastname: Cassaro Strunz
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Nicolau
authors.forename: Paulo Sampaio
authors.initials: PS
authors.lastname: Gutierrez
mesh_terms: D000368:Aged; D052279:Creatine Kinase, MB Form / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000473:pathology; D009206:Myocardium / Q000473:pathology; D009336:Necrosis; D011237:Predictive Value of Tests; D014336:Troponin / Q000097:blood*
chemical_list: D014336:Troponin; D052279:Creatine Kinase, MB Form