Document Detail

Creatine kinase subform analysis in hemodialysis patients without acute coronary syndromes.
MedLine Citation:
PMID:  9226229     Owner:  NLM     Status:  MEDLINE    
The finding of elevated levels of creatine kinase (CK) and its myocardial isoenzyme (CK MB) in the blood of patients with acute chest pain syndromes is a key factor in making the diagnosis of acute myocardial infarction. With the widespread use of thrombolytic therapy and emergency angioplasty, the ability to make a rapid and accurate diagnosis of myocardial infarction is critical. A new rapid method for analysis of the subforms of the MB isoenzyme has been shown to be sensitive and specific for the diagnosis of myocardial infarction in the general population. Because of its rapidity it has been replacing standard analyses of total CK and CK MB in some centers in guiding the initial therapy of patients with chest pain. Levels of CK MB can be abnormally elevated in hemodialysis patients even in the absence of acute myocardial necrosis. This study was undertaken in order to determine if subform analysis of the MB isoenzyme could similarly be abnormal in hemodialysis patients without acute coronary syndromes. CK MB subforms were analyzed in 52 patients without any recent cardiac symptoms who came into the dialysis unit for a routine hemodialysis treatment. We then applied the same criteria for the diagnosis of an acute myocardial infarction as would be used clinically. In this population, the subform analysis was surprisingly consistent with myocardial infarction in approximately 29% of the patients. Thus, subform analysis appears likely to result in an erroneous diagnosis of acute myocardial infarction in patients on hemodialysis.
M J Robbins; E M Epstein; S Shah
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Nephron     Volume:  76     ISSN:  0028-2766     ISO Abbreviation:  Nephron     Publication Date:  1997  
Date Detail:
Created Date:  1997-09-22     Completed Date:  1997-09-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0331777     Medline TA:  Nephron     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  296-9     Citation Subset:  IM    
Department of Medicine, St. John's-Queens Hospital, Elmhurst, N.Y., USA.
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MeSH Terms
Acute Disease
Biological Markers
Coronary Disease / diagnosis,  enzymology
Creatine Kinase / blood*
False Positive Reactions
Kidney Failure, Chronic / enzymology,  therapy
Myocardial Infarction / diagnosis*,  enzymology*
Renal Dialysis*
Reg. No./Substance:
0/Biological Markers; 0/Isoenzymes; EC Kinase

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