November 1, 1988Clinical Chemistry

Use of creatine kinase MB isoenzyme for diagnosing myocardial infarction when total creatine kinase activity is high.

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Why the study?

Does measuring creatine kinase MB isoenzyme improve the diagnosis of myocardial infarction in patients with total creatine kinase > 1000 U/L?

Population

146 patients with total creatine kinase activity > 1000 U/L, MB isoenzyme > 10 U/L and < 5% of total…

Comparison

Creatine kinase MB isoenzyme measurement to… vs Different cutoff values.

Design

Cohort

Authors

WTWarren G. ThompsonMayo Clinic RMR G MahrUniversity of Tübingen WYW S YohannanNew York University

Discussion

Member takes

Implication

CK-MB >2% of total may aid MI diagnosis when CK >1000 U/L; hypothesis-generating and requires prospective validation before practice change.

Structured PICO

Does measuring creatine kinase MB isoenzyme improve the diagnosis of myocardial infarction in patients with total creatine kinase > 1000 U/L?

Population

146 patients with total creatine kinase activity > 1000 U/L, MB isoenzyme > 10 U/L and < 5% of total creatine kinase, from an urban hospital serving a largely indigent population.

Intervention

Creatine kinase MB isoenzyme measurement (isoimmune method) to diagnose myocardial infarction.

Comparator

Different cutoff values (e.g., >10 U/L, >4% of total creatine kinase, >2% of total creatine kinase).

Outcome

Positive predictive value for diagnosing myocardial infarction.

In patients with markedly elevated total creatine kinase (>1000 U/L), a creatine kinase MB fraction >2% is the most appropriate cutoff for diagnosing myocardial infarction to balance false positives and missed cases.

Cite This Study

Thompson et al. (1988) studied this question.

synapsesocial.com/papers/6a8c33eeb560cb13f3c45e27 https://doi.org/10.1093/clinchem/34.11.2208

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Implication

CK-MB >2% of total may aid MI diagnosis when CK >1000 U/L; hypothesis-generating and requires prospective validation before practice change.

Use of creatine kinase MB isoenzyme for diagnosing myocardial infarction when total creatine kinase activity is high.

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Use of creatine kinase MB isoenzyme for diagnosing myocardial infarction when total creatine kinase activity is high.

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Also Consider

Also Consider