Key result
First-time MI without prior angina is linked to ~87% higher peak CK levels.
Why the study?
The extent of acute myocardial infarction in patients with or without previous angina or healed MI was unclear.
Does the absence of previous angina or healed MI correlate with higher peak CK and CK-MB levels in patients with acute MI?
Observational (n=177)
Does the absence of previous angina or healed MI correlate with higher peak CK and CK-MB levels in patients with acute MI?
Answers are grounded in this paper and cite their sources.
Patients experiencing acute MI without a history of angina or prior MI have significantly higher peak CK and CK-MB levels, suggesting larger infarct sizes possibly due to a lack of ischemic preconditioning.
The hypothesis that acute myocardial infarction (MI) is more extensive in patients without previous angina or healed MI was evaluated in 177 patients with documented recent acute MI. Ninety-nine patients (56%) had no previous angina or healed MI (negative history group), and the remaining 78 patients (44%) had a previous history of angina or healed MI (positive history group). The mean peak creatine kinase (CK) level in the negative history group was 784 compared with 419 IU in the positive history group (p less than 0.0001). The mean peak CK-MB level in the negative history group was 128 compared with 76 IU in the positive history group (p less than 0.001). The mean peak CK-MB level was higher in the negative history group after controlling for age, streptokinase administration, previous coronary artery bypass grafting or treatment with beta-blocking agents. Despite the high frequency of healed MI in the positive history group (73%), the rates of in-hospital complications were similar for the 2 groups. Patients with acute MI without previous angina or healed MI have substantially higher peak CK and CK-MB levels; this implies a larger MI than in patients with previous angina or healed MI.
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Brush et al. (1988) conducted an observational in acute myocardial infarction (n=177). Absence of previous angina or healed MI vs. Previous history of angina or healed MI was evaluated on peak creatine kinase (CK) level (p=<0.0001). Patients with acute MI without previous angina or healed MI had higher mean peak creatine kinase levels than those with a previous history.
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