Peak creatine kinase as a measure of effectiveness of thrombolytic therapy in acute myocardial infarction
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Authors
Gore, Joel M.Roberts, Robert
Ball, Steven P.
Montero, Alfredo
Goldberg, Robert J.
Dalen, James E.
UMass Chan Affiliations
Department of Medicine, Division of Cardiovascular MedicineDocument Type
Journal ArticlePublication Date
1987-06-01Keywords
AngiographyClinical Trials as Topic
Coronary Circulation
Creatine Kinase
Female
Fibrinolytic Agents
Humans
Male
Middle Aged
Myocardial Infarction
Streptokinase
Tissue Plasminogen Activator
Cardiology
Cardiovascular Diseases
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Show full item recordAbstract
As part of the National Heart, Lung, and Blood Institute multicenter Thrombolysis in Myocardial Infarction Trial, the time to peak plasma creatine kinase (CK) activity as a marker of reperfusion in 272 patients with validated acute myocardial infarction was analyzed. Patients were treated with either tissue-type plasminogen activator or streptokinase by intravenous administration. All patients underwent acute coronary angiography. The infarct-related artery was identified and thrombolytic therapy administered. Reperfusion at 90 minutes was documented by angiography. CK was determined before institution of therapy and every 4 hours thereafter for the first 24 hours. Patients were classified into 3 groups for comparative purposes: group 1--occlusion with no reperfusion (n = 119); group 2--occlusion with reperfusion (n = 98); and group 3--subtotal occlusion (n = 55). Early (within 4 hours after treatment) and late (more than 16 hours after treatment) peaking of CK differentiated patients with drug-induced perfusion from those without reperfusion. Although peak CK between 5 and 11 hours after drug treatment did suggest perfusion through the infarct-related artery, it did not differentiate between drug-induced and spontaneous reperfusion. Clinically, early peak CK is a useful noninvasive means of assessing coronary artery patency. However, in clinical trials assessing drug therapy, the use of peak CK may overestimate drug effectiveness by including patients with spontaneous reperfusion.Source
Gore JM, Roberts R, Ball SP, Montero A, Goldberg RJ, Dalen JE. Peak creatine kinase as a measure of effectiveness of thrombolytic therapy in acute myocardial infarction. Am J Cardiol. 1987 Jun 1;59(15):1234-8. doi: 10.1016/0002-9149(87)90896-4. PMID: 3109227.
DOI
10.1016/0002-9149(87)90896-4Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47059PubMed ID
3109227Related Resources
ae974a485f413a2113503eed53cd6c53
10.1016/0002-9149(87)90896-4