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Creatine kinase: race-gender differences in patients hospitalized for suspected myocardial infarction
J C Cook1, E Wong, L J Haywood
1Department of Medicine, Los Angeles County/University of Southern California Medical Center 90033.
Insights
Creatine kinase levels show significant race and gender differences in patients with suspected heart attacks. Standard ranges may need adjustment to account for these variations in diverse populations.
Area of Science:
- Biochemistry
- Clinical Chemistry
- Cardiology
Background:
- Creatine kinase (CK) is a key enzyme indicator for myocardial infarction.
- Existing reference ranges for CK may not adequately represent diverse populations.
- Understanding demographic influences on CK levels is crucial for accurate diagnosis.
Purpose of the Study:
- To investigate race and gender variations in creatine kinase (CK) values.
- To determine if standard CK reference ranges are universally applicable.
- To inform the potential need for race- and gender-specific CK diagnostic criteria.
Main Methods:
- Analysis of serial CK values from 647 patients admitted for suspected myocardial infarction.
- Comparison of lowest CK values across different racial and gender groups.
- Statistical analysis using both standard and log-transformed CK values.
- Assessment of body surface area as a potential confounding factor.
Main Results:
- Significant differences in CK values were observed between Hispanic females and black males using standard values.
- Log-transformed CK values revealed significant variations among black, Caucasian, and Hispanic individuals.
- Males exhibited higher log-CK values than females, but sex differences within racial groups were not significant.
- Body surface area differences partially explained but did not fully account for observed race-gender variations.
Conclusions:
- Race and gender significantly influence creatine kinase levels.
- Current standard reference ranges for CK may require reevaluation.
- Data strongly support the need for race- and gender-specific reference ranges for creatine kinase to improve diagnostic accuracy.
Abstract:
Race-gender differences in creatine kinase values were studied in 647 consecutive patients admitted for suspected myocardial infarction. The lowest value in a serial set for each patient was used for group comparisons. Significant differences were found between Hispanic females and black males, using standard values. Using log creatine kinase values, significant differences were found among blacks, Caucasians, and Hispanics. Males had higher log creatine kinase values than females, but no differences were found between sexes within racial groups. Body surface area differences (significant between males and females) did not explain all of the racial-gender differences found. Reexamination of ranges of normality, taking into account race-gender differences, is strongly supported by these data.