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Clinical Chemistry 39: 488-495, 1993;
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Clinical Chemistry, Vol 39, 488-495, Copyright © 1993 by American Association for Clinical Chemistry

Diagnostic evaluation of creatine kinase-2 mass and creatine kinase-3 and -2 isoform ratios in early diagnosis of acute myocardial infarction

V Bhayana, S Cohoe, FY Leung, G Jablonsky and AR Henderson
Department of Clinical Biochemistry, University Hospital (University of Western Ontario), London, Canada.

The diagnostic efficacy of creatine kinase (CK) isoforms (CK-3 and CK- 2) was compared with measurement of CK-2 mass concentrations for the early diagnosis of myocardial infarction (MI). Serial serum samples drawn from 76 patients with confirmed MI and 55 non-MI patients were used for determining CK-2 mass concentrations and the MM3/MM1 (CK-3 isoforms) and MB2/MB1 (CK-2 isoforms) ratios. We compared the diagnostic utility of each by receiver-operating-characteristic (ROC) curve and likelihood ratio analyses. Our results indicate that all three tests were ineffective within the first 4 h after the onset of chest pain. All three were most effective at 4-18 h after onset, but both CK-3 and CK-2 isoform ratios were less effective than CK-2 mass concentrations in the next 6-h period (18-24 h). In the critical time between 3 and 6 h, the diagnostic performance of all three was comparable.


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J.H. Keffer, V. Bhayana, A. R. Henderson, D. A. Propp, G. E. Lane, G. Gilson, R. Roberts, P. Puleo, and C. W. Hamm
Subforms of Creatine Kinase MB in the Diagnosis of Myocardial Infarction
N. Engl. J. Med., March 2, 1995; 332(9): 608 - 610.
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