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Infarct size estimation from serial CK MB determinations: peak activity and predictability.

J W Fiolet, H F ter Welle, F J van Capelle

    British Heart Journal
    |April 1, 1983
    PubMed
    Summary
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    Peak creatine kinase MB activity reliably estimates total enzyme release in acute myocardial infarction patients. This finding offers a more practical clinical approach than complex release calculations for diagnosing heart attacks.

    Area of Science:

    • Biochemistry
    • Cardiology
    • Clinical Diagnostics

    Background:

    • Acute myocardial infarction (AMI) diagnosis relies on cardiac enzyme markers.
    • Creatine kinase isoenzyme MB (CK MB) is a key biomarker for myocardial damage.
    • Accurate quantification of CK MB release is crucial for assessing infarct size.

    Purpose of the Study:

    • To evaluate the reliability of peak plasma CK MB activity as an estimate of total CK MB release in AMI patients.
    • To determine the clinical practicability of using peak CK MB activity compared to complex release calculations.

    Main Methods:

    • Serial plasma CK MB measurements at 4-hour intervals in 198 AMI patients.
    • Calculation of apparent first-order inactivation constant (kd) in a subgroup of 28 patients.

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  • Comparison of peak CK MB activity with calculated total release (Q and Q*) using individual and mean kd values.

    • Main Results:

    • A strong linear relationship was observed between peak CK MB activity and calculated total CK MB release (Q and Q*) across a wide range of activities.
    • This linearity was consistent regardless of whether a one or two-compartment model was used and for kd values up to 0.4 h-1.
    • Calculated CK MB release curves showed similarity, suggesting potential for early prediction of total release (Q(40)) with acceptable precision.

    Conclusions:

    • Peak CK MB activity serves as a reliable and clinically more practicable estimate of cumulative CK MB release in AMI.
    • The linear relationship and similarity of release curves support the use of peak activity for clinical assessment.
    • Early prediction of total CK MB release may be feasible using these findings.