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Significance of elevated MB creatine kinase in patients after cardiac catheterization
Insights
Elevated MB creatine kinase (CK) after cardiac catheterization is uncommon. The study suggests these increases likely indicate cardiac muscle injury, not skeletal muscle damage from the procedure itself.
Area of Science:
- Cardiology
- Biochemistry
Background:
- Plasma MB creatine kinase (CK) elevations post-cardiac catheterization require etiological clarification.
- Cardiac catheterization and coronary arteriography are common diagnostic procedures.
Purpose of the Study:
- To investigate the causes of elevated plasma MB CK levels in patients following cardiac catheterization.
- To differentiate between cardiac and skeletal muscle injury as sources of MB CK release.
Main Methods:
- Studied 32 consecutive patients undergoing cardiac catheterization and coronary arteriography.
- Measured total CK and MB CK levels before and after the procedure.
- Analyzed changes in MB CK activity in relation to normal ranges.
Main Results:
- Total CK activity significantly increased post-catheterization.
- MB CK activity showed a statistically significant but small mean increase (1.8 IU/1).
- Only one patient exceeded the normal MB CK range, suggesting minimal cardiac injury.
Conclusions:
- Marked elevations in MB CK after cardiac catheterization are unusual.
- Post-catheterization MB CK increases are more likely due to cardiac muscle injury.
- Skeletal muscle injury from the catheterization procedure is an unlikely cause for significant MB CK elevation.
Abstract:
To clarify the etiology of elevations in plasma MB creatine kinase (CK) in patients after cardiac catheterization, we studied 32 consecutive patients undergoing cardiac catheterization and coronary arteriography. Total CK and MB CK were within the normal range in all patients prior to catheterization. Total CK activity rose from a mean of 61.46 +/- 33.8 IU/1 (SD) to 141 +/- 105 in the first sample after catheterization (p less than .005) and 121.6 +/- 92.4 in the second catheterization sample (p less than .0005). The MB CK activity also rose from a mean of 3.2 +/- 1.6 IU/1 prior to catheterization to a maximum value of 5.0 +/- 2.9. The mean increase in MB CK, though statistically significant (p less than .005), was only 1.8 IU/1. Only one patient's value for MB CK rose to outside of the normal range (greater than 12) likely due to cardiac injury. Thus, our data document that marked elevations in MB CK after cardiac catheterization are unusual. They likely represent cardiac muscle injury rather than MB CK released due to skeletal muscle injury induced by the catheterization itself.