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Serum MB-creatine kinase is not elevated in active rheumatic carditis
Insights
Serum creatine kinase MB (CK-MB) is not a reliable indicator for assessing rheumatic carditis activity. Total creatine kinase (CK) levels can be elevated by intramuscular injections, not necessarily indicating cardiac issues.
Area of Science:
- Biochemistry
- Cardiology
- Rheumatology
Background:
- Rheumatic carditis can affect cardiac function and may alter serum enzyme levels.
- Creatine kinase (CK) and its MB fraction (CK-MB) are cardiac biomarkers, but their utility in rheumatic carditis requires clarification.
Purpose of the Study:
- To evaluate the diagnostic value of total serum creatine kinase (CK) and CK-MB in patients with active rheumatic carditis.
- To investigate the influence of intramuscular injections and disease activity on CK and CK-MB levels.
Main Methods:
- Serum total CK and CK-MB activities were measured in 36 patients with active rheumatic carditis and 33 healthy controls.
- Subgroup analysis was performed on carditis patients who received intramuscular injections (IMI).
- Repeat assays were conducted on 10 carditis patients after rheumatic activity subsided.
Main Results:
- No significant differences in total CK or CK-MB were observed between carditis patients and controls.
- Patients with prior IMI showed significantly elevated total CK, but not CK-MB.
- Total CK levels in carditis patients decreased after remission, but not significantly, while CK-MB remained unchanged.
Conclusions:
- CK-MB is not a valuable marker for assessing rheumatic carditis activity.
- Elevated total CK levels in clinical settings should consider potential confounding factors like IMI and bed rest.
Abstract:
Total serum creatine kinase (CK) and the MB fraction of CK (CK-MB) activities were measured in 36 patients with active rheumatic carditis and on 33 controls. There were no significant differences in either the total CK or the CK-MB between the two groups. However, eight out of the 36 carditis patients had received intramuscular injections (IMI) prior to the assay: this sub-group showed a significant elevation of the total CK but not the CK-MB. Ten carditis patients (without prior IMI) had repeat assays done after their rheumatic activity had subsided: the mean total CK, but not the CK-MB, fell to levels below control values although these were not statistically significant. The results show that CK-MB is not of value in assessing activity in rheumatic carditis. Further, in assessing the significance of elevated total CK in any clinical situation, the influence of IMI and of bed rest should be taken into account.