Comparison of MB fraction of creatine kinase mass and troponin I serum levels with necropsy findings in acute myocardial infarction

Am J Cardiol. 2008 Feb 1;101(3):311-4. doi: 10.1016/j.amjcard.2007.08.037. Epub 2007 Dec 20.

Abstract

Serum levels of troponin and heart-related fraction of creatine kinase (CK-MB) mass are used as diagnostic and prognostic criteria in myocardial infarction, but the relation between those levels and the necropsy-determined size of necrosis has not been tested in human beings. In this retrospective study, 1-cm-thick transverse sections of the ventricles were cut from the base to the apex in the necropsy hearts of 27 patients aged 47 to 86 years (mean 66, median 69; 19 men). Total and necrotic areas were measured using a computer-linked image analysis system. The weights of the necrotic areas were also calculated. The correlations of the areas and weights of necrotic myocardium with the highest serum values of CK-MB mass and troponin I, which had been quantified during life by chemiluminescence immunoassays, were verified by Pearson's test; results were considered significant at p<or=0.05. Significant correlations were detected between CK-MB mass peak and infarct size (r=0.63, p<0.01) and weight (r=0.69, p<0.01) and between CK-MB mass and highest troponin level (r=0.73, p<0.01); however, the correlations between highest troponin level and myocardial infarct size (r=0.31, p=0.11) and weight (r=0.35, p=0.07) were small and nonsignificant. In conclusion, despite the well-established role of serum levels of troponin as a diagnostic tool for myocardial infarction, their highest values showed poor correlations with the extent of infarct. In contrast, the highest serum level of CK-MB mass was well correlated with myocardial infarct size.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Creatine Kinase, MB Form / blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / blood*
  • Myocardial Infarction / pathology
  • Myocardium / pathology
  • Necrosis
  • Predictive Value of Tests
  • Troponin / blood*

Substances

  • Troponin
  • Creatine Kinase, MB Form