An Update on Cardiac Enzymes

  • Peter R. Puleo
    Corresponding Author: Section of Cardiology, Baylor College of Medicine, One Baylor Place, Room 512D, Houston, TX 77030
    Assistant Professor of Medicine, Bugher Foundation Center for Molecular Biology, Baylor College of Medicine; Director of Coronary Care, Ben Taub General Hospital; and Attending Physician, The Methodist Hospital, Houston, Texas
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  • Robert Roberts
    Professor of Medicine; Director, Bugher Foundation Center for Molecular Biology; Chief of Cardiology, Baylor College of Medicine; and Chief of Cardiology, The Methodist Hospital, Houston, Texas
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      Determination of plasma total and MB creatine kinase (CK) concentration provides accuracy superior to any other currently available method for the diagnosis of acute myocardial infarction. Nevertheless, elevation of MB CK is occasionally detected in the absence of acute myocardial infarction for a variety of reasons, some of them assaydependent; consequently, the clinician should suspect a noncardiac source of MB CK or a spurious result if assay determinations are discordant with the clinical setting. In addition to providing precise diagnosis of acute myocardial infarction, quantitative MB CK assays can also be used to obtain an accurate estimate of infarct size. The advent of thrombolytic therapy of acute myocardial infarction has emphasized the need for more sensitive early biochemical markers of necrosis and reperfusion; the newly discovered subforms of MM and MB CK show promise as a means of providing an early diagnosis of acute myocardial infarction and also as a means of assessing reperfusion noninvasively.
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