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Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
Published on: October 14, 2016
High early peak creatine kinase after thrombolysis in patients with acute anterior infarction predicts poor left
D Freimark1, S Matetzky, H Hod
1Heart Institute, Sheba Medical Center, Tel-Hashomer, Tel-Aviv University, Israel.
Insights
Following thrombolysis for acute myocardial infarction (AMI), peak creatine kinase (CK) levels still indicate heart damage. Higher peak CK values correlate with reduced left ventricular ejection fraction (LVEF), showing impaired heart function.
Area of Science:
- Cardiology
- Biochemistry
Background:
- Successful thrombolysis in acute myocardial infarction (AMI) modifies creatine kinase (CK) release patterns.
- Key alterations include an earlier CK peak and higher peak values relative to infarct size.
Purpose of the Study:
- To investigate if peak CK magnitude post-thrombolysis accurately reflects myocardial damage extent.
- To correlate peak CK levels with left ventricular ejection fraction (LVEF) in patients with anterior AMI.
Main Methods:
- Analysis of 114 patients with first anterior AMI treated with thrombolysis.
- Correlation of peak CK values with LVEF at admission and 2 months post-treatment.
- Categorization of patients based on early peak CK (< or = 12 hours).
Main Results:
- A significant linear relationship (p < 0.001) was found between peak CK and LVEF at both time points.
- High peak CK (>= 1,500 IU/l) was significantly associated with lower LVEF (p < 0.001).
- Patients with high early peak CK showed a higher incidence of poor LVEF (p < 0.05).
Conclusions:
- Peak CK magnitude remains a valuable indicator of myocardial damage extent after successful thrombolysis for AMI.
- Elevated peak CK levels post-thrombolysis predict worse left ventricular function.
Abstract:
Successful thrombolysis alters the pattern of creatine kinase (CK) release to the plasma after acute myocardial infarction (AMI). Among the important differences there are the early peak of the CK activity curve and the higher peak value for a given infarct size. To determine whether the magnitude of peak CK following thrombolysis still reflects the extent of myocardial damage, we correlated the peak CK value with left ventricular ejection fraction (LVEF) in 114 patients with first anterior AMI who had early peak CK ( < or = 12 h) after thrombolysis. There was a significant (p < 0.001) linear relation between the peak CK value and LVEF both at admission and 2 months later. High ( > or = 1,500 IU/1) as compared with low early peak CK was associated with significantly lower LVEF (p < 0.001) and a higher incidence of poor LVEF (p < 0.05).
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