Serum CPK isoenzymes after cardiac catheterization

Area of Science:

• Cardiology
• Biochemistry
• Diagnostic Medicine

Background:

• Preoperative exclusion of acute myocardial infarction is crucial for successful coronary revascularization.
• Conventional serum enzymes (AST, LDH, total CPK) can be falsely elevated post-cardiac catheterization due to non-cardiac sources.
• MB CPK isoenzyme, primarily found in heart muscle, offers greater specificity for cardiac injury.

Purpose of the Study:

• To evaluate the reliability of MB CPK isoenzyme activity in diagnosing myocardial infarction.
• To compare MB CPK levels with total CPK in patients undergoing cardiac catheterization.

Main Methods:

• Serum total CPK and MB CPK activities were measured in 53 patients before and 24 hours after cardiac catheterization.
• MB CPK levels were also assessed in 50 patients with confirmed acute myocardial infarction and 20 healthy controls.
• Procedures included selective coronary arteriography via brachial or femoral artery approaches.

Main Results:

• Patients with acute myocardial infarction showed significantly elevated total CPK and MB CPK levels.
• Control subjects without cardiovascular disease had normal MB CPK activity (<0.004 IU/ml).
• Patients undergoing catheterization had elevated total CPK but normal MB CPK levels, indicating no myocardial infarction.

Conclusions:

• Elevated MB CPK isoenzyme activity is a specific and reliable indicator of myocardial infarction.
• MB CPK is a superior biomarker compared to total CPK for diagnosing myocardial infarction in patients who have undergone cardiac catheterization.
• This finding aids in accurate preoperative assessment and management of patients undergoing coronary revascularization.