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March 1, 1987Clinical Chemistry

Early diagnosis of acute myocardial infarction by rapid analysis of creatine kinase isoenzyme-3 (CK-MM) sub-types.

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Why the study?

Does the measurement of CK-3 (MM) sub-types improve the early diagnostic efficiency of acute myocardial infarction compared to CK-2 (MB) isoenzymes?

Population

69 patients, comprising 35 with acute myocardial infarction and 34 non-infarction patients.

Comparison

Measurement of creatine kinase-3 isoenzyme… vs Measurement of creatine kinase-2 isoenzymes by…

Design

Cohort

Follow-up

Up to 21 hours

Authors

AWAiming WuSun Yat-sen UniversityTGTerrie G. GornetThe University of Texas MD Anderson Cancer CenterVWVickie WuIcahn School of Medicine at Mount Sinai

Discussion

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Implication

CK-3 subtyping may aid early MI diagnosis; leaves open validation against high-sensitivity troponin in prospective cohorts.

Key Points

  • To compare the diagnostic efficiency, sensitivity, and specificity of creatine kinase-3 (MM) isoenzyme subtypes against creatine kinase-2 (MB) for diagnosing acute myocardial infarction.
  • Assessed serial blood collections at 3-hour intervals from 35 acute myocardial infarction patients (with or without pharmacological thrombolysis and coronary angioplasty) and 34 non-infarction controls.
  • Measured CK-3 subtypes using anion-exchange liquid chromatography and a modified high-voltage electrophoresis method, and quantified CK-2 via immunoprecipitation.
  • CK-3 subtypes exhibited the highest diagnostic efficiency during the initial 3 to 9 hours following the onset of chest pain.
  • CK-2 isoenzymes demonstrated peak diagnostic efficiency during the subsequent 10- to 21-hour post-onset interval.

Structured PICO

Does the measurement of CK-3 (MM) sub-types improve the early diagnostic efficiency of acute myocardial infarction compared to CK-2 (MB) isoenzymes?

P
Population
69 patients, comprising 35 with acute myocardial infarction (some treated with pharmacological thrombolysis with or without coronary angioplasty) and 34 non-infarction patients.
I
Intervention
Measurement of creatine kinase-3 (MM) isoenzyme sub-types by anion-exchange liquid chromatography and modified high-voltage electrophoresis.
C
Comparator
Measurement of creatine kinase-2 (MB) isoenzymes by immunoprecipitation.
O
Outcome
Clinical sensitivity, specificity, and diagnostic efficiency for the diagnosis of acute myocardial infarction.surrogate

CK-3 sub-type measurement offers superior diagnostic efficiency compared to CK-2 for the early detection of acute myocardial infarction within 3 to 9 hours of symptom onset.

Cite This Study

Wu et al. (1987) studied this question.

synapsesocial.com/papers/6a8989894c30e1095aec7ae2https://doi.org/10.1093/clinchem/33.3.358
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Creatine kinase MM isoenzyme subforms in myocardium, cardiac lymph and blood after coronary artery occlusion in dogs1984 · 18 citations
  2. 2Evaluation and comparison of immunoinhibition and immunoprecipitation methods for differentiating MB and BB from macro forms of creatine kinase isoenzymes in patients and healthy individuals.1982 · 70 citations
  3. 3Early detection of myocardial infarction in conscious dogs by analysis of plasma MM creatine kinase isoforms.1985 · 49 citations
  4. 4Activities of some enzymes in serum after therapy with intracoronary streptokinase in acute myocardial infarction.1984 · 32 citations
  5. 5Nonoperative Dilatation of Coronary-Artery Stenosis1979 · 2,423 citations