Circulation, Vol 74, 105-109, Copyright © 1986 by American Heart Association
AS Jaffe, H Serota, A Grace and BE Sobel
Conventional plasma isoenzyme and enzyme values usually are normal during
the first few hours of acute myocardial infarction. Thus definitive
diagnosis may be delayed. We have shown recently that infarction in dogs
can be detected within 1 hr after coronary occlusion by analysis of
relative activities of MM creatine kinase (CK) isoforms in plasma. Isoforms
of MM CK evolve through posttranslational modifications in plasma of the
form released from tissue (MMA) to MMB and MMC. In this study we quantified
changes in isoform profiles in the first available plasma samples from
patients with evolving myocardial infarction, from patients with angina,
and from normal subjects. In the 26 control subjects, the ratio of MMA to
MMC was 1.09 +/- 0.4 (SE) (range 0.31 to 3.1; upper limit of normal
[defined as the mean plus 2 SD] 2.5). In the seven control patients with
coronary artery disease, the ratio of MMA to MMC was 1.3 +/- 0.3 with a
range of 0.5 to 2.5. In contrast, among the 28 patients with acute
myocardial infarction, the ratio of MMA to MMC in the first available
plasma sample averaged 14.6 +/- 4.5 (p less than .01 compared with both
control groups). First available samples were obtained 3.9 +/- 0.4 hr after
the onset of pain. In 24 of 28 patients (86%) the ratio of MMA to MMC was
greater than 2.5.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Diagnostic changes in plasma creatine kinase isoforms early after the onset of acute myocardial infarction
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