Abstract
The value of serum creatine kinase B subunit activity (CK B) in the diagnosis of acute myocardial infarction was studied in 238 consecutive cases. All were admitted to a coronary care unit because of suspected acute myocardial infarction. Serum CK B activity was determined by an immunoinhibition procedure, using a CK M subunit inhibiting antibody (anti-M). For the evaluation of serum CK B, patients were classified into acute myocardial infarction and non-acute myocardial infarction groups. This classification was based on electrocardiographic findings, on quantitative determinations of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total serum creatine kinase (CK) activities, and on qualitative electrophoretic determinations of serum CK and serum lactate dehydrogenase (LD) isoenzymes. The prevalence of acute myocardial infarction in the patient material was 0.47. Serum CK B subunit activity was found to be a highly selective indicator of acute myocardial infarction with a predictive value of a positive test result of 0.97 and a predictive value of a negative test result of 0.99. The serum CK B activity increased above the acute myocardial infarction discrimination limit within 12 hours from onset of symptoms. Two non-acute myocardial infarction patients, who were resuscitated after cardiac arrest, had increased serum CK B values caused by the transient presence of CK isoenzyme BB in serum.
Full text
PDF








Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Blomberg D. J., Kimber W. D., Burke M. D. Creatine kinase isoenzymes. Predictive value in the early diagnosis of acute myocardial infarction. Am J Med. 1975 Oct;59(4):464–469. doi: 10.1016/0002-9343(75)90253-3. [DOI] [PubMed] [Google Scholar]
- Byrnes A. C., Alter S. Letter: Important to separate creatine kinase isoenzyme BB? Clin Chem. 1975 Nov;21(12):1845–1846. [PubMed] [Google Scholar]
- Ehsani A., Ewy G. A., Sobel B. E. Effects of electrical countershock on serum creatine phosphokinase (CPK) isoenzyme activity. Am J Cardiol. 1976 Jan;37(1):12–18. doi: 10.1016/0002-9149(76)90492-6. [DOI] [PubMed] [Google Scholar]
- Feld R. D., Witte D. L. Presence of creatine kinase BB isoenzyme in some patients with prostatic carcinoma. Clin Chem. 1977 Oct;23(10):1930–1932. [PubMed] [Google Scholar]
- Gerhardt W., Ljungdahl L., Börjesson J., Hofvendahl S., Hedenas B. Creatine kinase B-subunit activity in human serum. I. Development of an immunoinhibition method for routine determination of S-creatine kinase B-sununit activity. Clin Chim Acta. 1977 Jul 1;78(1):29–41. doi: 10.1016/0009-8981(77)90335-7. [DOI] [PubMed] [Google Scholar]
- Gerhardt W., Waldenström J. Creatine kinase B-subunit activity in serum after immunoinhibition of M-subunit activity. Clin Chem. 1979 Jul;25(7):1274–1280. [PubMed] [Google Scholar]
- Henry P. D., Roberts R., Sobel B. E. Rapid separation of plasma creatine kinase isoenzymes by batch adsorption on glass beads. Clin Chem. 1975 Jun;21(7):844–849. [PubMed] [Google Scholar]
- Itano M. The detection of CPK1 (BB) in serum. A summary of sixteen cases. Am J Clin Pathol. 1976 Mar;65(3):351–355. doi: 10.1093/ajcp/65.3.351. [DOI] [PubMed] [Google Scholar]
- Jockers-Wretou E., Grabert K., Müller E., Pfleiderer G. Serum creatine kinase isoenzyme pattern in nervous system atrophies and neuromuscular disorders. Clin Chim Acta. 1976 Nov 15;73(1):183–186. doi: 10.1016/0009-8981(76)90322-3. [DOI] [PubMed] [Google Scholar]
- Kaste M., Somer H., Konttinen A. Brain-type creatine kinase isoenzyme. Occurrence in serum in acute cerebral disorders. Arch Neurol. 1977 Mar;34(3):142–144. doi: 10.1001/archneur.1977.00500150028004. [DOI] [PubMed] [Google Scholar]
- Klein M. S., Shell W. E., Sobel B. E. Serum creatine phosphokinase (CPK ) isoenzymes after intramuscular injections, surgery, and myocardial infarction. Experimental and clinical studies. Cardiovasc Res. 1973 May;7(3):412–418. doi: 10.1093/cvr/7.3.412. [DOI] [PubMed] [Google Scholar]
- Konttinen A., Somer H. Determination of serum creatine kinase isoenzymes in myocardial infarction. Am J Cardiol. 1972 Jun;29(6):817–820. doi: 10.1016/0002-9149(72)90501-2. [DOI] [PubMed] [Google Scholar]
- Lederer W. H., Gerstbrein H. L. Creatine kinase isoenzyme BB activity in serum of a patient with gastric cancer. Clin Chem. 1976 Oct;22(10):1748–1749. [PubMed] [Google Scholar]
- Ljungdahl L., Gerhardt W. Creatine kinase isoenzyme variants in human serum. Clin Chem. 1978 May;24(5):832–834. [PubMed] [Google Scholar]
- Ljungdahl L., Hofvendahl S., Gerhardt W., Börjesson J. Creatine kinase B-subunit activity in human serum. II. Evaluation of s-ck b-subunit activity in the diagnosis of acute myocardial infarction. Clin Chim Acta. 1977 Jul 1;78(1):43–53. doi: 10.1016/0009-8981(77)90336-9. [DOI] [PubMed] [Google Scholar]
- Marmor A., Grenadier E., Palant A. Assay of creatinine kinase isoenzymes in heart-disease. Lancet. 1977 Nov 19;2(8047):1087–1088. doi: 10.1016/s0140-6736(77)91933-x. [DOI] [PubMed] [Google Scholar]
- Meltzer H. Y., Mrozak S., Boyer M. Effect of intramuscular injections on serum creatine phosphokinase activity. Am J Med Sci. 1970 Jan;259(1):42–48. doi: 10.1097/00000441-197001000-00006. [DOI] [PubMed] [Google Scholar]
- Mercer D. W. Separation of tissue and serum creatine kinase isoenzymes by ion-exchange column chromatography. Clin Chem. 1974;20(1):36–40. [PubMed] [Google Scholar]
- Morin L. G. Improved separation of creatine kinase cardiac isoenzyme in serum by batch fractionation. Clin Chem. 1976 Jan;22(1):92–97. [PubMed] [Google Scholar]
- Nealon D. A., Henderson A. R. Separation of creatine kinase isoenzymes in serum by ion-exchange column chromatography (Mercer's method, modified to increase sensitivity). Clin Chem. 1975 Mar;21(3):392–397. [PubMed] [Google Scholar]
- Neumeier D., Hofstetter R. Radioimmunoassay for subunit B in isoenzymes CK-MB and CK-BB of creatine phosphokinase. Clin Chim Acta. 1977 Aug 15;79(1):107–113. doi: 10.1016/0009-8981(77)90467-3. [DOI] [PubMed] [Google Scholar]
- Neumeier D., Prellwitz W., Würzburg U., Brundobler M., Olbermann M., Just H-J, Knedel M., Lang H. Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction. Clin Chim Acta. 1976 Dec;73(3):445–451. doi: 10.1016/0009-8981(76)90146-7. [DOI] [PubMed] [Google Scholar]
- Nordlander R. Enzymes in acute myocardial infarction. Diagnosis with special reference to creatine kinase MB isoenzyme. Acta Med Scand Suppl. 1978;623:18–26. doi: 10.1111/j.0954-6820.1979.tb00693.x. [DOI] [PubMed] [Google Scholar]
- Roberts R., Parker C. W., Sobel B. E. Detection of acute myocardial infarction by radioimmunoassay for creatine kinase MB. Lancet. 1977 Aug 13;2(8033):319–322. doi: 10.1016/s0140-6736(77)91484-2. [DOI] [PubMed] [Google Scholar]
- Roberts R., Sobel B. E. Ediortial: Isoenzymes of creatine phosphokinase and diagnosis of myocardial infarction. Ann Intern Med. 1973 Nov;79(5):741–743. doi: 10.7326/0003-4819-79-5-741. [DOI] [PubMed] [Google Scholar]
- Rosalki S. R. Standardisation of isoenzyme assays with special reference to lactate dehydrogenase isoenzyme electrophoresis. Clin Biochem. 1974 Mar;7(1):29–40. doi: 10.1016/s0009-9120(74)90232-x. [DOI] [PubMed] [Google Scholar]
- Smith A. F., Radford D., Wong C. P., Oliver M. F. Creatine kinase MB isoenzyme studies in diagnosis of myocardial infarction. Br Heart J. 1976 Mar;38(3):225–232. doi: 10.1136/hrt.38.3.225. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Somer H., Konttinen A. Demonstration of serum creatine kinase isoenzymes by fluorescence technique. Clin Chim Acta. 1972 Aug;40(1):133–138. doi: 10.1016/0009-8981(72)90260-4. [DOI] [PubMed] [Google Scholar]
- Sunderman F. W., Jr Current concepts of "normal values," "reference values," and "discrimination values," in clinical chemistry. Clin Chem. 1975 Dec;21(13):1873–1877. [PubMed] [Google Scholar]
- Wagner G. S., Roe C. R., Limbird L. E., Rosati R. A., Wallace A. G. The importance of identification of the myocardial-specific isoenzyme of creatine phosphokinase (MB form) in the diagnosis of acute myocardial infarction. Circulation. 1973 Feb;47(2):263–269. doi: 10.1161/01.cir.47.2.263. [DOI] [PubMed] [Google Scholar]
- Weseley S. A., Byrnes A., Alter S., Solangi K. B., Goodman A. I. Presence of creatine phosphokinase brain band in the serum of chronic renal disease patients. Clin Nephrol. 1977 Aug;8(2):345–348. [PubMed] [Google Scholar]
