Normal CK, elevated MB predicts complications in acute coronary syndromes

W. Frank Peacock, Charles L. Emerman, Ellen S. McErlean, Sue A. DeLuca, Frederick VanLente, Marsha Lowrie, Jonnagadda S Rao, Steven E. Nissen

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

The implications of an elevated Creatine kinase (CK)-MB isoenzyme (MB) in suspected acute coronary syndromes, with a normal total CK, is not well established. Despite many guidelines on managing patients with acute coronary ischemia, none indicates strategies for patients with elevated MB and with a normal CK. The outcome consequence of this result is not firmly established. Our objective was to prospectively evaluate outcomes in patients with suspected acute coronary syndromes, normal initial total CK, and increased MB. All Emergency Department patients with suspected acute coronary syndromes and creatinine <2.0 mg/dL were eligible for study entry. Serial CK and MB fractions were measured on arrival in the Emergency Department, then 8 and 16 h postpresentation. A composite outcome of death, Q-wave myocardial infarction, or revascularization was defined at the index visit and 6 months later. Outcomes were determined by blinded record review and by telephone contact. In the 698 patients entered, the acute composite outcome rate was 25% (175) and 6.3% (44) at 6 months. Acute and 6 month adverse outcome rates were statistically the same for all patients with an elevated MB fraction, regardless of the total CK level. An elevated MB conferred a higher event rate than did a normal MB. We conclude that the adverse event rate for patients with suspected acute coronary syndromes and an elevated MB is the same whether or not the total CK is elevated. These patients should be considered as having had an acute coronary syndrome.

Original languageEnglish
Pages (from-to)385-390
Number of pages6
JournalJournal of Emergency Medicine
Volume20
Issue number4
DOIs
StatePublished - May 28 2001
Externally publishedYes

Fingerprint

MB Form Creatine Kinase
Acute Coronary Syndrome
Creatine Kinase
Hospital Emergency Service
Myocardial Revascularization
Telephone
Isoenzymes
Creatinine
Ischemia
Myocardial Infarction
Guidelines

Keywords

  • Chest pain
  • Creatine kinase
  • Emergency medicine
  • Myocardial infarction
  • Unstable angina

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Peacock, W. F., Emerman, C. L., McErlean, E. S., DeLuca, S. A., VanLente, F., Lowrie, M., ... Nissen, S. E. (2001). Normal CK, elevated MB predicts complications in acute coronary syndromes. Journal of Emergency Medicine, 20(4), 385-390. https://doi.org/10.1016/S0736-4679(01)00317-1

Normal CK, elevated MB predicts complications in acute coronary syndromes. / Peacock, W. Frank; Emerman, Charles L.; McErlean, Ellen S.; DeLuca, Sue A.; VanLente, Frederick; Lowrie, Marsha; Rao, Jonnagadda S; Nissen, Steven E.

In: Journal of Emergency Medicine, Vol. 20, No. 4, 28.05.2001, p. 385-390.

Research output: Contribution to journalArticle

Peacock, WF, Emerman, CL, McErlean, ES, DeLuca, SA, VanLente, F, Lowrie, M, Rao, JS & Nissen, SE 2001, 'Normal CK, elevated MB predicts complications in acute coronary syndromes', Journal of Emergency Medicine, vol. 20, no. 4, pp. 385-390. https://doi.org/10.1016/S0736-4679(01)00317-1
Peacock WF, Emerman CL, McErlean ES, DeLuca SA, VanLente F, Lowrie M et al. Normal CK, elevated MB predicts complications in acute coronary syndromes. Journal of Emergency Medicine. 2001 May 28;20(4):385-390. https://doi.org/10.1016/S0736-4679(01)00317-1
Peacock, W. Frank ; Emerman, Charles L. ; McErlean, Ellen S. ; DeLuca, Sue A. ; VanLente, Frederick ; Lowrie, Marsha ; Rao, Jonnagadda S ; Nissen, Steven E. / Normal CK, elevated MB predicts complications in acute coronary syndromes. In: Journal of Emergency Medicine. 2001 ; Vol. 20, No. 4. pp. 385-390.
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