SUMMARY The effect of i.v. nitroglycerin administration on indexes of infarct size was examined in 31 patients with acute myocardial infarction. Serial creatine kinase (CK) and CK-MB isoenzyme determinations were used to calculate infarct size. Twenty-nine patients served as controls. Two subgroups of the study group were formed to evaluate differences between early and late intervention. In the first group (n = 22), continuous infusion of nitroglycerin over 48 hours was initiated within 8 hours (mean 4.5 hours) after the onset of symptoms. Peak CK activity for the nitroglycerin-treated patients (n = 9) in this subgroup was 544 U/1 vs 871 U/1 for the controls (n = 13) (p < 0.05). The rate of CK release was reduced from 79 to 33 U/1.hr (58%), as was total CK and CK-MB release (p < 0.02 (fig. 3).The f^ollowing additional measurements were determined using a computer program developed by Shell et al. '5 16 (1) Individual appearance curves of CK and CK-MB, including the quantity of enzymes normally lost through excretion, were standardized to 0 hour.(2) The rate of CK and CK-MB release was calculated as 90% of total appearance divided by the time to 90% appearance (U/l.hr17).(3) The disappearance rate (kd) was derived from the end part of the CK and CK-MB curve by the best fit regression line.'8
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