Three rapid immunoassays for the determination of creatine kinase MB: An analytical, clinical, and interpretive evaluation

Wolfson, David J.; Lindberg, Eric; Su, Lyndon D.; Farber, Sergio J.; Dubin, Stuart B.

doi:10.1016/0002-8703(91)90458-t

Cited by 38 publications

(6 citation statements)

References 16 publications

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“…Although the measurement of the MB subunit of CK (CK‐MB), and the ratio of CK‐MB and total CK activity have been considered the `gold standard' amongst the molecular markers for the diagnosis of myocardial necrosis, some false positive results have been reported in renal failure, and in chronic or acute muscle damage; this latter is almost inevitable in surgery [27‐34].…”

Section: Diagnosismentioning

confidence: 99%

Perioperative myocardial infarction in noncardiac surgery: the diagnostic and prognostic role of cardiac troponins

Lucreziotti

Foroni

Fiorentini

2002

Journal of Internal Medicine

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Despite the number of technologies used, the diagnosis of perioperative myocardial infarction is still a challenge. Studies conducted in surgical series have demonstrated that cardiac troponins (cTns) have both a superior diagnostic sensitivity and specificity, compared with other traditional techniques, and an independent power to predict short-and long-term prognosis. Nevertheless, some points need to be clarified. They include the usefulness of cTns in patients with end-stage renal failure; the standardization of the cTns cut-off for the diagnosis of myocardial injury; the timing of postoperative blood samplings; the cost-effectiveness of a screening in asymptomatic patients; and the possible therapeutic strategies.

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Section: Diagnosismentioning

confidence: 99%

Perioperative myocardial infarction in noncardiac surgery: the diagnostic and prognostic role of cardiac troponins

Lucreziotti

Foroni

Fiorentini

2002

Journal of Internal Medicine

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“…The isoenzyme myocardium-specific creatine kinase (CK-MB) is expressed in the myocardium and CK in the skeletal muscle cells. These two enzymes have traditionally been analysed in plasma to distinguish myocardial injury and skeletal muscle injury [8, 9]. Troponins have been shown to be more specific and sensitive to cardiac injury [10, 11].…”

Section: Introductionmentioning

confidence: 99%

Clinical and biochemical prediction of early fatal outcome following hip fracture in the elderly

Talsnes¹,

Hjelmstedt

Dahl

et al. 2010

International Orthopaedics (SICOT)

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Hip fracture, a moderate musculoskeletal trauma, is associated with a high postoperative mortality. Most patients are elderly, with comorbid conditions and often with heart disease. The objective of this study was to find out if clinical parameters and analyses of specific muscle enzymes could predict three month postoperative mortality. A total of 302 patients above 75 years of age with hip fracture were consecutively enrolled. Baseline information on age, sex and comorbidity assessed with the American Society of Anesthesiologists (ASA) score was obtained before surgery. Creatine kinase (CK), myocardium-specific creatine kinase (CK-MB) and troponin T (TnT) were analysed from venous blood, collected the day before surgery (−1) and postoperatively, within 24 hours (0) and on days one (+1) and four (+4). The overall three month mortality was 19.5%. Multivariate analyses showed that age, male sex and comorbidity (ASA) correlated with mortality (p = 0.027, p = 0.002, p < 0.001, respectively). Surgery induced a two- to threefold increase of CK and CK-MB but without any correlation with mortality. However, high TnT levels >0.04 μg/l correlated significantly with death (days −1, +1 and +4, p = 0.003, p = 0.005 and p = 0.003, respectively). Multivariate analyses, adjusted for age, sex and ASA category, confirmed this correlation (day +4, p = 0.008). Thus, in elderly patients with comorbidities undergoing hip fracture surgery information on sex, age, ASA category and postoperative laboratory analyses on TnT provide the clinicians with useful information on patients at risk of fatal outcome.

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“…For this purpose, not only the specificity and sensitivity of the marker used are of great importance, but also the time necessary to measure a single serum in an emergency laboratory. On the other hand, creatine kinase and its MB isoenzyme or myoglobin are not specific for myocardial injury, but they can be performed within a few minutes (12). On the other hand, creatine kinase and its MB isoenzyme or myoglobin are not specific for myocardial injury, but they can be performed within a few minutes (12).…”

Section: Discussionmentioning

confidence: 99%

Technical Reports

1997

Clinical Chemistry and Laboratory Medicine

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We evaluated a rapid, quantitative immunoassay for the detection of cardiac troponin I. Coefficient of variation is between 1.29 and 13.63% for intra-assay and between 3.88 and 10.15% for inter-assay imprecision. Linearity is given up to 35 g/l. Possible interfering substances (haemoglobin, bilirubin, triacylglycerol and rheuma factors) do not disturb the assay. The analyte is stable under normal storage conditions (+20 °C/48 h and + 4 °C/1 week) with decrease up to 30% after 3 months at -20 °C. Reference value for apparently healthy individuals is < 0.1 §/1. In plasma cardiac troponin I is measured up to 30% depressed compared to serum. Comparison with another cardiac troponin I assay (y = 0.92x + 2.42, r = 0.940) and cardiac troponin T is good with y = 6.6Ix -1.94, r = 0.91 for the first generation cardiac troponin T assay and y = 5.59x -0.68, r = 0.87 for the second generation cardiac troponin T assay.In summary, the evaluated assay is fast, easy to perform, and can be used not only in a specialized laboratory, but is also suitable for emergency laboratory or smaller laboratory units.

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Three rapid immunoassays for the determination of creatine kinase MB: An analytical, clinical, and interpretive evaluation

Cited by 38 publications

References 16 publications

Perioperative myocardial infarction in noncardiac surgery: the diagnostic and prognostic role of cardiac troponins

Perioperative myocardial infarction in noncardiac surgery: the diagnostic and prognostic role of cardiac troponins

Clinical and biochemical prediction of early fatal outcome following hip fracture in the elderly

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