Copyright © 1992 by the European Society of Cardiology.
© 1992 The European Society of Cardiology
Increased CKMB (mass concentration) in patients without traditional evidence of acute myocardial infarction. A risk indicator of coronary death
From theCoronary Care Unit, Central Hospital Kristianstad, Sweden
*Department of Internal Medicine and the Department of Clinical Chemistry Kristianstad, Sweden
Received 24 October 1991; revised 16 April 1992; .
Correspondence: Thomas Peltersson, Department of Internal Medicine, Central Hospital, S-291 85 Kristianstad, Sweden
Abstract
A study of 102 patients consecutively admitted to a coronary care unit (CCU) investigated the clinical usefulness of three different immunoenzymometrical CKMB methods: NovoClone CK-MB, ICON QSR CKMB and IMx CK-MB. Blood samples were drawn on admission and then every 6 h for 48 h. The three different methods correlated very well (r=0·93–0·96). With discrimination levels of 10µg . I–1for NovoClone CK-MB and 5µg. I–1for the other two methods, a sensitivity of 10 and a still acceptable specificity (>0·81) were achieved.
In the group of patients (n=53) with suspicion of acute myocardial infarction (AMI) but with no standard criteria for AMI, 14 patients were identified with small but significant increase of serum CKMB (mass concentration) and an increased CKMB (mass concentration)/CK ratio. During a 4 year follow-up nine out of these 14 patients died within 2 years, the majority being coronary deaths, as compared to only two out of the remaining 39 non-AMI patients with suspicion of A MI but with normal CKMB values (x2=18·47, P<0·001). The finding of such a high mortality rate among patients with increased CKMB (mass concentration) has an important prognostic value even in patients without standard criteria for A MI.
Key Words: Acute myocardial infarction • CKMB (mass concentration) • creatine kinase isoenzyme MB • unstable angina pectoris
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