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Clinical Chemistry 43: 338-343, 1997;
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(Clinical Chemistry. 1999;43:338-343.)
© 1999 American Association for Clinical Chemistry, Inc.

Articles

Critical difference between serial measurements of CK-MB mass to detect myocardial damage

Robbert J. de Winter1,a, Rudolph W. Koster1, Jan P. van Straalen2, Jozef P. M. C. Gorgels2, Frans J. Hoek2 and Gerard T. Sanders2

1 Academic Medical Center, Departments of Cardiology and
2 Clinical Chemistry, University of Amsterdam, The Netherlands.
a Address correspondence to this author, at: Department of Cardiology, Suite G3-231, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam. Fax 31-20-6915687.

To assess the critical difference in serial measurements of CK-MBmass and the ability of this critical difference to detect myocardial damage, we studied 110 patients in whom an acute myocardial infarction (AMI) had been ruled out. Blood samples were drawn at 3, 4, 5, 6, 7, 8, 12, 16, 20, and 24 h after onset of symptoms. With a critical difference of 72.6%, an increase of >2.0 µg/L between two CK-MBmass measurements was determined to be significant. Twenty-three of the non-AMI patients had an increase in CK-MBmass >2.0 µg/L, but five of these did not have an abnormal concentration of troponin T (i.e., not >0.1 µg/L). Also among the 110 non-AMI patients, 22 did have an abnormal troponin T value, 18 of whom (82%) also had CK-MBmassincreased by >2.0 µg/L. In 20 of the 23 patients with an increase in CK-MBmass >2.0 µg/L, this increase was detected from the values for two samples collected at 5 and 12 h after onset of symptoms. In conclusion, using the critical difference for CK-MBmassdefined as an increase >2.0 µg/L detected myocardial damage in patients without AMI.


Key Words: indexing terms: variation, source of • creatine kinase • isoenzymes • troponin T




The following articles in journals at HighWire Press have cited this article:


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 HeartHome page
R Bholasingh, R J de Winter, J C Fischer, R W Koster, R J G Peters, and G T Sanders
Safe discharge from the cardiac emergency room with a rapid rule-out myocardial infarction protocol using serial CK-MBmass
Heart, February 1, 2001; 85(2): 143 - 148.
[Abstract] [Full Text]


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Copyright © 1997 by the American Association for Clinical Chemistry.