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Creatine Kinase Isozyme Measurements in Patients With Suspected Myocardial Infarction

Creatine Kinase Isozyme Measurements in Patients With Suspected Myocardial Infarction Abstract To the Editor. —We read with interest the study by Fisher et al,1 published in the August 1983 Archives, on the use of enzyme measurements for the diagnosis of acute myocardial infarction (MI). They demonstrated clearly that total serum creatine kinase (CK) and CK isozyme measurements are sufficient in determining acute MI, and that additional enzymatic assays should only be done when the CK results have been equivocal. We would like to point out, however, that their conclusions have been reached in a hospital in which CK isozyme assays are done accurately by a method differ ent from the immunoinhibition method used in many places. The immunoinhibition method uses blocking antibodies, which selectively inhibit the activity of the CK-M subunit in CK-MM and in CK-MB, and only the enzymatic activity of the B part of the CK-MB and CK-BB is left intact.2 Since most of the CK-BB activity References 1. Fisher ML, Kelemen MH, Collins D, et al: Routine serum enzyme tests in the diagnosis of acute myocardial infarction: Cost-effectiveness. Arch Intern Med 1983;143:1541-1543.Crossref 2. Würzburg U: Measurements of creatine kinase isoenzyme activity by immunological methods , in Lang H (ed): Creatine Kinase Isoenzymes: Pathophysiology and Clinical Application . New York, Springer-Verlag Inc, 1981, pp 49-67. 3. Bohner J, Stein W, Steinhart R, et al: Macro-creatine kinases: Results of isoenzyme electrophoresis and differentiation of the immunoglobulin-bound type by radioassay. Clin Chem 1982;28:618-623. 4. Lang H, Würzburg U: Creatine kinase: An enzyme of many forms. Clin Chem 1982;28: 1439-1447. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Creatine Kinase Isozyme Measurements in Patients With Suspected Myocardial Infarction

Archives of Internal Medicine , Volume 144 (5) – May 1, 1984

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Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1984.00350170255044
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. —We read with interest the study by Fisher et al,1 published in the August 1983 Archives, on the use of enzyme measurements for the diagnosis of acute myocardial infarction (MI). They demonstrated clearly that total serum creatine kinase (CK) and CK isozyme measurements are sufficient in determining acute MI, and that additional enzymatic assays should only be done when the CK results have been equivocal. We would like to point out, however, that their conclusions have been reached in a hospital in which CK isozyme assays are done accurately by a method differ ent from the immunoinhibition method used in many places. The immunoinhibition method uses blocking antibodies, which selectively inhibit the activity of the CK-M subunit in CK-MM and in CK-MB, and only the enzymatic activity of the B part of the CK-MB and CK-BB is left intact.2 Since most of the CK-BB activity References 1. Fisher ML, Kelemen MH, Collins D, et al: Routine serum enzyme tests in the diagnosis of acute myocardial infarction: Cost-effectiveness. Arch Intern Med 1983;143:1541-1543.Crossref 2. Würzburg U: Measurements of creatine kinase isoenzyme activity by immunological methods , in Lang H (ed): Creatine Kinase Isoenzymes: Pathophysiology and Clinical Application . New York, Springer-Verlag Inc, 1981, pp 49-67. 3. Bohner J, Stein W, Steinhart R, et al: Macro-creatine kinases: Results of isoenzyme electrophoresis and differentiation of the immunoglobulin-bound type by radioassay. Clin Chem 1982;28:618-623. 4. Lang H, Würzburg U: Creatine kinase: An enzyme of many forms. Clin Chem 1982;28: 1439-1447.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: May 1, 1984

References