Clinical measurement of myocardial infarct size. Modification of a method for the estimation of total creatine phosphokinase release after myocardial infarction.

Norris, R. M.; Whitlock, R. M. L.; Barratt-Boyes, C; Small, C.W.

doi:10.1161/01.cir.51.4.614

Cited by 250 publications

(67 citation statements)

References 27 publications

(6 reference statements)

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“…It is known that CK levels begin to rise a few hours after onset, and it has been reported that the peak CK value reflects the extent of damage to the myocardium, or in other words, infarct size. 5,6) One report has even suggested that in-hospital mortality is directly related to peak-CK, 12) and that high peak-CK was associated with lower left-ventricular systolic function, compared to low peak-CK. 13) In the clinical setting, early peak-CK is a useful noninvasive means of assessing coronary artery patency.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Significance of Time-delay to Peak Creatine Kinase After Direct Percutaneous Coronary Intervention in Acute Myocardial Infarction Patients

et al. 2005

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SUMMARYThe aim of the present study was to investigate the prognostic significance of timedelay to peak creatine kinase (CK) after successful direct percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).Our 240 consecutive first AMI attack subjects admitted within 5 hours from onset were successfully reperfused by direct PCI therapy. Subjects were divided into two groups according to the upper quartile value of peak-CK time from onset, the early peak-CK group (peak-CK time ≤ 16 hours from onset, n = 180) and the late peak-CK group (peak-CK time > 16 hours, n = 60).(I) The early ST-segment resolution rate was lower in the late peak-CK group compared with the early peak-CK group (P < 0.05), and there were significantly fewer patients with preinfarction angina pectoris in the late peak-CK group than in the early peak-CK group (P < 0.01). (II) LVEF in the chronic stage was significantly lower in the late peak-CK group than in the early peak-CK group (49 ± 13% versus 57 ± 13%, P < 0.001). (III) There were significantly more patients with major complications in the late peak-CK group than in the early peak-CK group (required CABG: 10% versus 3%, P < 0.05; cardiac death: 18% versus 3%, P = 0.0001). (IV) Multivariate analysis identified late peak-CK as an independent predictor of cardiac death (Odds ratio 7.91, 95% C.I. 1.40-44.11, P < 0.05).In patients with AMI, the time-delay to peak-CK after successful direct PCI may be closely related to left-ventricular systolic dysfunction and poor patient outcome, including mortality. (Int Heart J 2005; 46: 771-781)

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Section: Discussionmentioning

confidence: 99%

“…5,6) This time is, however, significantly shorter for patients treated with recanalization therapy as compared with those treated using conventional medical methods. 8,9) Indeed, in our study, the mean value of peak-CK time was as short as 11 hours.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Time-delay to Peak Creatine Kinase After Direct Percutaneous Coronary Intervention in Acute Myocardial Infarction Patients

et al. 2005

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“…CK-MB is a marker of cytosolic damage that reflects the area at risk and the resultant size of the infarction, 28 whereas TnT is a marker of myofibril damage and is elevated in proportion to infarct size per se. 29,30 Thus, the STE-ACS group with transmural infarction had a larger infarct size than the NSTE-ACS group.…”

Section: Differences Between Nste-acs and Ste-acs Patientsmentioning

confidence: 99%

Difference in Elevation of N-Terminal Pro-BNP and Conventional Cardiac Markers Between Patients With ST Elevation vs Non-ST Elevation Acute Coronary Syndrome

Ogawa

Seino

Yamashita

et al. 2006

Circ J

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Background N-terminal pro-B-type natriuretic peptide (NT-proBNP) is elevated in patients with acute coronary syndrome (ACS), and is a powerful predictor of long-term mortality. Differences in the clinical utility and pathophysiological implication of NT-proBNP and conventional cardiac markers in patients with ST elevation (STE) vs non-STE (NSTE) ACS were investigated in the present study. Methods and ResultsNinety consecutive patients admitted with acute chest pain and a diagnosis of unstable angina or acute myocardial infarction were analyzed. Patients with ≥Killip class II were excluded to focus on the effect of myocardial ischemia on the release of cardiac markers. The markers were measured on admission and analyzed according to the time from onset. Conventional cytosolic marker (creatine kinase-MB) and myofibril marker (troponin T: TnT) were both significantly higher in STE-ACS patients compared with NSTE-ACS patients. Conversely, NT-proBNP was significantly higher in NSTE-ACS patients than STE-ACS especially within 3 h of onset, suggesting a larger ischemic insult despite the smaller extent of myocardial necrosis compared with STE-ACS patients. There was no significant correlation between NT-proBNP level and left ventricular ejection fraction (LVEF) obtained at acute-phase echocardiography in either NSTE-ACS patients (LVEF 57.7±11.2%) or STE-ACS patients (LVEF 55.1±12.7%). Comparison between NT-proBNP and TnT levels revealed a marked difference of elevations, with significantly augmented elevation of NT-proBNP (p<0.001) in NSTE-ACS patients as compared with prominent elevation of TnT in STE-ACS patients. Conclusions NT-proBNP is an early sensitive marker of myocardial ischemia that rises much higher in the earlier phase as compared with conventional markers of myocardial damage, especially in NSTE-ACS patients. (Circ J 2006; 70: 1372 -1378

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“…CK-MB and troponin T were measured in blood samples obtained every 3-12 h after arrival in the emergency room for at least 4 days. CK-MB levels were measured using an immuno-inhibition method and the amount of CK-MB released was calculated using the method developed by Norris et al 31 Troponin T levels were measured using an enzyme immunoassay method and the peak troponin T level was recorded. Secondary endpoints assessed were complications reported during the 30-day follow-up, including recurrent ischemia (spontaneous occurrence and in exercise-loading tests), reocclusion, reinfarction, blood transfusion, and cerebral bleeding.…”

Section: Study Endpointsmentioning

confidence: 99%

An Early and Complete Reperfusion Strategy for Acute Myocardial Infarction Using Fibrinolysis and Subsequent Transluminal Therapy. The FAST Trial.

Nagao

Hayashi

Kanmatsuse

et al. 2002

Circ J

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oronary thrombolysis has been shown to be beneficial and effective for the treatment of acute myocardial infarction (AMI) in many clinical randomized megatrials [1][2][3][4][5][6][7][8][9][10][11] and is now established as the standard reperfusion therapy. [12][13][14][15] However, the patency rate of the infarct-related artery (IRA) ranges between 60% and 80% with this treatment, and reocclusion occurs in 5-15% of cases. [16][17][18][19] The alternative therapy of primary percutaneous transluminal coronary angioplasty (PTCA) can achieve a recanalization rate as high as 90%, 20-24 but needs to be carried out within a short time frame. 14 In 1999, the American College of Cardiology/American Heart Association (ACC/AHA) guidelines for the management of patients with AMI stated that primary PTCA is an alternative therapy for thrombolysis if it is performed in a timely fashion (balloon inflation within 90±30 min of admission) by persons skilled in the procedure and supported by experienced personnel in an appropriate laboratory environment. 15 The most crucial requirement for reperfusion therapy in AMI is not skill, but the earliest possible achievement of complete and sustained reperfusion. To this end, cocktail therapies using thrombolytic agents plus platelet glycoprotein IIb/IIIa inhibitors, 25,26 combination therapy with glycoprotein IIb/IIIa inhibitors and primary coronary intervention, 27 and a combination of thrombolysis and coronary intervention 28 have been attempted.The protocol for fibrinolysis and subsequent transluminal (FAST) therapy was prepared to establish a strategy for reperfusion therapy that complies with the 1996 ACC/AHA guidelines for the management of patients with AMI. 14 FAST therapy aims for the earliest possible thrombolysisin-myocardial-infarction grade 3 (TIMI-3) flow in the IRA after arrival in the emergency room.This study evaluated the efficacy and safety of FAST therapy. The FAST I trial using the tissue-type plasminogen activators (t-PA) alteplase or tisokinase as thrombolytic agents was performed from 1997 to 1998, and the FAST II trial comparing t-PA with the mutant t-PA monteplase was performed from 1998 to 1999. Methods Study SubjectsThe FAST trial was a prospective study conducted at 3 participating medical institutions. The study enrolled patients who presented after 30 min of continuous symptoms but within 12 h of the onset of symptoms of AMI and who had, on the basis of 12-lead electrocardiography (ECG) recording, ST-segment elevation of at least 0.1 mV in 2 or more limb leads, ST-segment elevation of at least 0.2 mV in the precordial leads, or bundle branch block. Patients were excluded from the study according to the following The efficacy and safety of fibrinolysis and subsequent transluminal (FAST) therapy were evaluated in 195 patients with acute myocardial infarction (AMI) for the early achievement of thrombolysis-in-myocardial-infarction grade 3 (TIMI-3) flow in the infarct-related artery. Intravenous thrombolysis using the optimal dose of a thrombolytic agent was in...

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Clinical measurement of myocardial infarct size. Modification of a method for the estimation of total creatine phosphokinase release after myocardial infarction.

Cited by 250 publications

References 27 publications

Prognostic Significance of Time-delay to Peak Creatine Kinase After Direct Percutaneous Coronary Intervention in Acute Myocardial Infarction Patients

Prognostic Significance of Time-delay to Peak Creatine Kinase After Direct Percutaneous Coronary Intervention in Acute Myocardial Infarction Patients

Difference in Elevation of N-Terminal Pro-BNP and Conventional Cardiac Markers Between Patients With ST Elevation vs Non-ST Elevation Acute Coronary Syndrome

An Early and Complete Reperfusion Strategy for Acute Myocardial Infarction Using Fibrinolysis and Subsequent Transluminal Therapy. The FAST Trial.

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