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. Billström, R. Ljungdahl, H. Berning, P. Bagger

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Abstract

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 noninfarct 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.

Original languageEnglish
JournalClinical Chemistry
Volume28
Issue number2
Pages (from-to)277-283
Number of pages7
ISSN0009-9147
Publication statusPublished - 26. Apr 1982

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Gerhardt, W., Waldenstrom, J., Horder, M., Hofvendahl, S., Billström, R., Ljungdahl, R., Berning, H., & Bagger, P. (1982). Creatine kinase and creatine kinase B-subunit activity in serum in cases of suspected myocardial infarction. Clinical Chemistry, 28(2), 277-283.