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Clinical Chemistry 28: 277-283, 1982;
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Clinical Chemistry, Vol 28, 277-283, Copyright © 1982 by American Association for Clinical Chemistry

Creatine kinase and creatine kinase B-subunit activity in serum in cases of suspected myocardial infarction

W Gerhardt, J Waldenstrom, M Horder, S Hofvendahl, R Billstrom, R Ljungdahl, H Berning and P Bagger

We evaluated a diagnostic strategy by studying 481 patients suspected of having had an acute myocardial infarction; the prevalence of infarction by independent criteria was 0.43. This strategy is based on the sequential application of: (a) clinical criteria; (b) total creatine kinase determinations in two serum samples drawn within 10 to 20 h of the onset of acute symptoms; and (c) creatine kinase B-subunit (S-CK B) determinations after immunoinhibition with antibodies to creatine kinase M-subunit in the reaction medium in all samples found to have increased total creatine kinase activity. Discrimination limits of 150 U/L total creatine kinase for women and 200 U/L for men gave a diagnostic sensitivity of 0.99. Activities less than these limits in samples identified 68% of the 274 non-infarct cases (posterior probability of a negative result of 0.99) within 20 h. Subsequent determination of S-CK B in 292 patients who were positive by the discrimination limits for total creatine kinase verified myocardial infarction in 99% of 207 cases for which S-CK B exceeded the discrimination limit of 12 U/L. The strategy excluded 98% of all non- infarct cases at a posterior probability of 0.99.


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O. Hetland and K. Dickstein
Cardiac troponins I and T in patients with suspected acute coronary syndrome: a comparative study in a routine setting
Clin. Chem., July 1, 1998; 44(7): 1430 - 1436.
[Abstract] [Full Text] [PDF]


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