Rate of disappearance of creatine kinase-MB after acute myocardial infarction

Clinical determinants of variability

Richard T. Lee, Thomas H. Lee, W. Kenneth Poole, Nancy Gustafson, Peter H. Stone, Allan S Jaffe, James E. Muller, Burton E. Sobel, Robert Roberts, Eugene Braunwald

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The apparent rate of disappearance (Kd) of creatine kinase (CK)-MB is used in the calculation of the size of acute myocardial infarction (AMI), but littie is known about the determinants of variability of this parameter. We therefore evaluated the relationship between clinical characteristics and apparent Kd in 328 patients with AMI without evidence of recurrent infarction. Patients with a history of cigarette smoking within 6 months had higher rates of disappearance of CK-MB, but no relationship was found between renal function and apparent Kd. Slower rates of disappearance of CK-MB were correlated with longer times from the onset of symptoms to peak CK-MB value (p < 0.001), while higher peak CK-MB levels were not correlated with apparent rates of enzyme clearance. Decreased rates of disappearance of CK-MB were found in patients who had congestive heart failure during or after the hospitalization (both p < 0.05), and who died during the hospitalization or during study follow-up (both p < 0.05). Slower rates of disappearance were also significantly correlated with lower ejection franctions on radionuclide ventriculography at 10 days (p < 0.001) and at 3 months (p < 0.05) after AMI. These data suggest that patients with slower rates of disappearance of CK-MB may have poorer prognoses, perhaps reflecting continuing necrosis and enzyme release from jeopardized myocardium.

Original languageEnglish (US)
Pages (from-to)1493-1499
Number of pages7
JournalAmerican Heart Journal
Volume116
Issue number6 PART 1
DOIs
StatePublished - 1988
Externally publishedYes

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MB Form Creatine Kinase
Myocardial Infarction
Hospitalization
Radionuclide Ventriculography
Enzymes
Infarction
Myocardium
Necrosis
Heart Failure
Smoking
Kidney

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Rate of disappearance of creatine kinase-MB after acute myocardial infarction : Clinical determinants of variability. / Lee, Richard T.; Lee, Thomas H.; Poole, W. Kenneth; Gustafson, Nancy; Stone, Peter H.; Jaffe, Allan S; Muller, James E.; Sobel, Burton E.; Roberts, Robert; Braunwald, Eugene.

In: American Heart Journal, Vol. 116, No. 6 PART 1, 1988, p. 1493-1499.

Research output: Contribution to journalArticle

Lee, RT, Lee, TH, Poole, WK, Gustafson, N, Stone, PH, Jaffe, AS, Muller, JE, Sobel, BE, Roberts, R & Braunwald, E 1988, 'Rate of disappearance of creatine kinase-MB after acute myocardial infarction: Clinical determinants of variability', American Heart Journal, vol. 116, no. 6 PART 1, pp. 1493-1499. https://doi.org/10.1016/0002-8703(88)90734-X
Lee, Richard T. ; Lee, Thomas H. ; Poole, W. Kenneth ; Gustafson, Nancy ; Stone, Peter H. ; Jaffe, Allan S ; Muller, James E. ; Sobel, Burton E. ; Roberts, Robert ; Braunwald, Eugene. / Rate of disappearance of creatine kinase-MB after acute myocardial infarction : Clinical determinants of variability. In: American Heart Journal. 1988 ; Vol. 116, No. 6 PART 1. pp. 1493-1499.
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abstract = "The apparent rate of disappearance (Kd) of creatine kinase (CK)-MB is used in the calculation of the size of acute myocardial infarction (AMI), but littie is known about the determinants of variability of this parameter. We therefore evaluated the relationship between clinical characteristics and apparent Kd in 328 patients with AMI without evidence of recurrent infarction. Patients with a history of cigarette smoking within 6 months had higher rates of disappearance of CK-MB, but no relationship was found between renal function and apparent Kd. Slower rates of disappearance of CK-MB were correlated with longer times from the onset of symptoms to peak CK-MB value (p < 0.001), while higher peak CK-MB levels were not correlated with apparent rates of enzyme clearance. Decreased rates of disappearance of CK-MB were found in patients who had congestive heart failure during or after the hospitalization (both p < 0.05), and who died during the hospitalization or during study follow-up (both p < 0.05). Slower rates of disappearance were also significantly correlated with lower ejection franctions on radionuclide ventriculography at 10 days (p < 0.001) and at 3 months (p < 0.05) after AMI. These data suggest that patients with slower rates of disappearance of CK-MB may have poorer prognoses, perhaps reflecting continuing necrosis and enzyme release from jeopardized myocardium.",
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