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[Cardiac enzymes in acute cerebrovascular diseases: their behavior in relation to ECG]
V Lovreglio1, G Bartucci, P Simini
1Ospedale S. Nicola Pellegrino, Trani, Bari.
Insights
Elevated creatine kinase (CK) and CK-MB enzyme levels in acute vascular cerebropathy (A.V.C.) patients indicate poor prognosis. These enzyme increases, particularly CK-MB, correlate with higher mortality rates, suggesting cardiac involvement.
Area of Science:
- Cardiology
- Neurology
- Biochemistry
Background:
- Acute vascular cerebropathy (A.V.C.) is a critical condition affecting the brain.
- Cardiac enzyme levels, such as creatine kinase (CK) and CK-MB, are used as biomarkers in various medical conditions.
- The prognostic significance of these enzymes in A.V.C. patients with concurrent electrocardiogram (ECG) changes requires further investigation.
Purpose of the Study:
- To investigate the correlation between blood enzyme levels (CK and CK-MB) and patient outcomes in A.V.C.
- To assess the prognostic value of elevated enzyme levels and ECG changes in A.V.C. patients.
Main Methods:
- Blood samples were collected from three groups: A.V.C. patients with ECG changes (Group A, n=13), A.V.C. patients with minimal/no ECG changes (Group B, n=10), and a control group (Group C).
- Levels of total creatine kinase (CPK) and creatine kinase MB (CPK MB) were measured over time.
- Statistical analysis, including comparison between groups (P < 0.01), was performed to determine significance.
Main Results:
- In A.V.C. patients, CPK and CPK MB levels increased between days 2-4 and 8-9, peaking on day 4.
- Group A showed a highly significant increase in CPK MB compared to Groups B and C (P < 0.01).
- Group A patients were older, had a higher mortality rate, and deaths often coincided with CPK and CPK MB peaks.
Conclusions:
- Elevated CPK and CPK MB levels, along with significant ECG changes, indicate an unfavorable prognosis in A.V.C. patients.
- Increased CPK MB suggests a myocardial issue that may contribute to mortality alongside cerebral damage.
- These enzyme markers are valuable for assessing prognosis and understanding the complex pathophysiology of A.V.C.
Abstract:
The blood levels of CPK and CPK MB enzymes were measured in 3 groups of patients: group A consists of 13 patients affected by acute vascular cerebropathy (A.V.C.) with evident ECG changes, group B consists of 10 patients showing fairly slight or no changes in the ECG and group C is the control group. It was noted that in patients affected by A.V.C., CPK and CPK values increase over a time span between the 2nd and 4th days and the 8th and 9th days of the condition, with peaks on the 4th day. The rise in CPK MB that reaches a highly significant statistical difference in group A compared to group B and C (P less than 0.01) is particularly interesting. Further, group A consists of older patients and is characterised by a larger number of deaths; death often coincides with peaks in CPK MB and in total CPK. It is therefore deduced that a high value of these enzymes, just as appreciable changes in ECG have an unfavourable prognostic value and that the increase in CPK MB expresses a real myocardial problem that probably contributes, along with the cerebral damage, to the death of the patient.