Modified creatine kinase-MB plots as a tool to detect perioperative myocardial infarction. Evaluation of sensitivity...

Area of Science:

• Cardiology
• Biochemistry
• Medical Diagnostics

Background:

• Coronary artery bypass grafting (CABG) is a major cardiac surgery.
• Perioperative myocardial infarction (PMI) is a significant complication following CABG.
• Accurate detection of PMI is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the diagnostic utility of serial creatine kinase-MB (CK-MB) activity for detecting PMI in CABG patients.
• To compare the effectiveness of CK-MB with electrocardiographic (ECG) criteria in identifying PMI.

Main Methods:

• Patients undergoing CABG were divided into two groups based on ECG criteria: one with PMI and one without.
• Serial measurements of total creatine kinase (CK) and CK-MB activity were performed postoperatively.
• Statistical analysis was used to compare biomarker levels and diagnostic performance.

Main Results:

• Serial total CK activity did not differentiate between patients with and without PMI.
• Serial CK-MB activity showed a distinct pattern: an increase in patients with PMI and a decrease in those without.
• CK-MB plots demonstrated high diagnostic accuracy, with a sensitivity of 0.92 and a specificity of 0.98 compared to ECG.

Conclusions:

• Serial CK-MB activity is a reliable biomarker for detecting perioperative myocardial infarction in CABG patients.
• CK-MB analysis provides superior diagnostic performance compared to total CK and is comparable to ECG criteria for PMI detection.