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Creatine kinase-mb fraction and cardiac troponin T to diagnose acute myocardial infarction after cardiopulmonary resuscitation
- Source :
- Journal of the American College of Cardiology. 28(5)
- Publication Year :
- 1996
-
Abstract
- Objectives.This study sought to evaluate the diagnostic value of the biochemical markers creatine kinase (CK), creatine kinase-MB fraction (CK-MB) and cardiac troponin T (cTNT) to diagnose acute myocardial infarction (AMI) after cardiopulmonary resuscitation (CPR).Background.Elevations of CK and CK-MB after CPR are a frequent finding and might be associated with ischemic myocardial injury, as well as physical trauma to the chest.Methods.Patients who had cardiac arrest and primary successful resuscitation were included in the study. The diagnosis of AMI was confirmed or ruled out by means of typical electrocardiographic findings, thallium-201 myocardial scintigraphy or autopsy, if death occurred during the hospital period, in 39 primary survivors of sudden cardiac death. In 24 patients (62%) the diagnosis of AMI was established. Serum cTNT, CK and CK-MB were measured, and the CK-MB/CK ratio was calculated on admission and after 12 h.Results.On admission all markers of myocardial injury proved to be weak methods for the diagnosis of AMI. After 12 h cTNT as well as CK-MB exhibited a similar diagnostic performance; CK and the CK-MB/CK ratio proved to be worthless. Sensitivity and specificity for a cTNT cutoff value of 0.6 ng/ml, 12 h after cardiac arrest, were 96% and 80%, respectively. For a CK-MB cutoff value of 26 U/liter, sensitivity was 96% and specificity was 73%.Conclusions.Cardiac TNT and CK-MB are valuable tools in detecting AMI as the cause of sudden cardiac death. However, there is a considerable lack of sensitivity and specificity. Cardiac injury is probably caused not only by AMI, but also by myocardial damage related to CPR efforts.
- Subjects :
- Male
medicine.medical_specialty
Resuscitation
Myocardial Infarction
macromolecular substances
Creatine
chemistry.chemical_compound
Electrocardiography
Troponin complex
Troponin T
Internal medicine
Medicine
Animals
Humans
cardiovascular diseases
Myocardial infarction
Creatine Kinase
biology
business.industry
Myocardium
Middle Aged
medicine.disease
Troponin
Cardiopulmonary Resuscitation
Isoenzymes
chemistry
biology.protein
Cardiology
Creatine kinase
Female
Myocardial infarction diagnosis
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 07351097
- Volume :
- 28
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Cardiology
- Accession number :
- edsair.doi.dedup.....ad3775627439576cb4cdff6398e59c37