Creatine kinase MM and MB isoforms in patients receiving thrombolytic therapy and acute angiography. TAMI Study Group
Christenson, R.H.; Ohman, E.M.; Topol, E.J.; O'Hanesian, M.A.; Sigmon, K.N.; Duh, S.H.; Kereiakes, D.; Worley, S.J.; George, B.S.; Pizzo, C.K.
Clinical Chemistry 41(6 Pt 1): 844-852
1995
ISSN/ISBN: 0009-9147 PMID: 7768002 Document Number: 448884
Creatine kinase isoforms markers, including MB-2 concentration, MB-2/MB-1 and MM-3/MM-1 ratios, and M-T index (based on the "tissue" M subunits), were measured in serial specimens from 207 patients receiving thrombolytic therapy followed by acute angiography. The slope of release showed a significant relation (P lt 0.05) between MB-2 concentrations and patency, graded as TIMI 0 through TIMI 3; with regard to the precatheterization/baseline ratio, the MB-2 concentrations, the MM-3/MM-1 ratio, and the M-T index were all significantly related to graded patency (P lt 0.004). Patients having patency graded as either TIMI 2/3 (Open) or TIMI 0/1 (Closed) showed highly significant differences (P lt 0.03) in the slope of release and precatheterization/baseline ratio for all markers except the MB-2/MB-1 ratio. Defining Open as TIMI 3 and Closed as TIMI 0/1/2 showed very similar results. Despite these significant differences between the Open and Closed groups after thrombolytic therapy, none of the C index calculations (areas under ROC curves) for any of the isoform markers-either alone or combined-exceeded 0.70, suggesting that these markers have limited diagnostic utility for assessing patency.