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Clinical Chemistry 41: 844-852, 1995;
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Clinical Chemistry, Vol 41, 844-852, Copyright © 1995 by American Association for Clinical Chemistry

Creatine kinase MM and MB isoforms in patients receiving thrombolytic therapy and acute angiography. TAMI Study Group

RH Christenson, EM Ohman, EJ Topol, MA O'Hanesian, KN Sigmon, SH Duh, D Kereiakes, SJ Worley, BS George and CK Pizzo
Department of Pathology, University of Maryland School of Medicine, Baltimore 21201, USA.

Creatine kinase isoforms markers, including MB2 concentration, MB2/MB1 and MM3/MM1 ratios, and MT index (based on the "tissue" M subunits), were measured in serial specimens from 207 patients receiving thrombolytic therapy followed by acute angiography. The slope of release showed a significant relation (P < 0.05) between MB2 concentrations and patency, graded as TIMI 0 through TIMI 3; with regard to the precatheterization/baseline ratio, the MB2 concentrations, the MM3/MM1 ratio, and the MT index were all significantly related to graded patency (P < 0.004). Patients having patency graded as either TIMI 2/3 (Open) or TIMI 0/1 (Closed) showed highly significant differences (P < 0.03) in the slope of release and precatheterization/baseline ratio for all markers except the MB2/MB1 ratio. Defining Open as TIMI 3 and Closed as TIMI 0/1/2 showed very similar results. Despite these significant differences between the Open and Closed groups after thrombolytic therapy, none of the C index calculations (areas under ROC curves) for any of the isoform markers-- either alone or combined--exceeded 0.70, suggesting that these markers have limited diagnostic utility for assessing patency.


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