title: Isolated creatine kinase-MB rise with normal cardiac troponins: a strange occurrence with difficult interpretation.
abstract: A 37-year-old man is admitted to the hospital for retrosternal chest pain lasting more than 30  min and nonspecific ECG findings. Serial assays of cardiac biomarkers reveal an isolated elevation of creatine kinase-MB and negative troponin levels. A coronary angiography shows normal vessels in the presence of a Thrombolysis in Myocardial Infarction (TIMI) 2 flow. How should this patient be managed and treated? Is it a myocardial infarction? We here provide a review of the relevant literature and suggest that such a strange condition, for which several explanations are possible, involves a worse prognosis than for normal creatine kinase-MB and troponins.
authors.affiliation: Institute of Cardiology, G. d'Annunzio University, Chieti, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Ricci
authors.forename: Raffaele
authors.initials: R
authors.lastname: De Caterina
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D000328:Adult; D000787:Angina Pectoris / Q000097:blood / Q000209:etiology*; D015415:Biomarkers / Q000097:blood; D002317:Cardiovascular Agents / Q000627:therapeutic use; D017023:Coronary Angiography; D052279:Creatine Kinase, MB Form / Q000097:blood*; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D013997:Time Factors; D016896:Treatment Outcome; D014336:Troponin / Q000097:blood*; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D002317:Cardiovascular Agents; D014336:Troponin; D052279:Creatine Kinase, MB Form