Circulating CK-MB and CK-BB isoenzymes after prostate resection

Area of Science:

• Biochemistry
• Clinical enzymology
• Urology

Background:

• Serum enzyme levels, including creatine kinase (CK) and lactate dehydrogenase (LDH), are crucial diagnostic markers.
• CK and LDH isoenzymes help differentiate tissue origins of enzyme elevations, particularly for cardiac versus non-cardiac sources.
• Prostate tissue itself contains CK isoenzymes, suggesting potential alterations post-surgery.

Purpose of the Study:

• To investigate the impact of prostate resection on serum CK and LDH isoenzyme profiles.
• To determine if post-prostatectomy CK elevations, specifically the MB isoenzyme, are indicative of cardiac injury.
• To assess the relationship between LDH isoenzyme shifts and postoperative hemolysis.

Main Methods:

• Serum samples were collected from 22 patients undergoing prostate resection.
• Creatine kinase (CK) and lactate dehydrogenase (LDH) isoenzyme activities were measured pre- and post-operatively.
• Analysis focused on total CK activity, CK-MB and CK-BB percentages, and the LDH-1/LDH-2 ratio.

Main Results:

• Two hours post-operation, 66% of patients showed increased total CK activity.
• CK-MB isoenzyme was detected in 66% of patients (1-7% of total CK), and CK-BB in 76% (1-29% of total CK).
• No evidence of cardiac damage was observed; post-prostatectomy CK-MB elevations were associated with increased CK-BB activity. LDH isoenzyme ratio inversion was infrequent and correlated with hemolysis.

Conclusions:

• Post-prostatectomy serum CK elevations, including CK-MB, do not necessarily indicate myocardial infarction.
• The presence of CK-MB after prostatectomy is likely due to the release of prostatic CK isoenzymes, predominantly BB, alongside some MB.
• LDH isoenzyme changes post-surgery are minimal and primarily related to the degree of hemolysis.