Circulation, Vol 70, 824-835, Copyright © 1984 by American Heart Association
DB Hackel, KA Reimer, RE Ideker, EM Mikat, TD Hartwell, CB Parker, EB Braunwald, M Buja, HK Gold and AS Jaffe
Enzymatic estimates of myocardial infarct size based on plasma levels of MB
creatine kinase (MB-CK) were compared with anatomic infarct size in 49
human hearts obtained at autopsy. The patients studied had been enrolled in
the Multicenter Investigation of Limitation of Infarct Size (MILIS) study
program within 18 hr of the onset of acute infarction and were treated at
one of five participating hospitals. Infarct size was estimated from serial
measurements of plasma MB-CK made at the core laboratory for CK analysis.
Hearts obtained at autopsy were studied independently by the core pathology
laboratory without knowledge of the MB-CK levels or clinical results. Data
from the two laboratories were compared at the data coordinating center. Of
49 hearts, 12 were excluded either because anatomic infarct size could not
be established or because the infarct occurring at the time of enrollment
in the MILIS study could not be distinguished with certainty from other
infarcts. Of the remaining 37 hearts, peak MB-CK level was available in 36,
but samples sufficient for estimation of infarct size were available in
only 25. The overall correlation coefficient (Spearman) was .87 for these
25 hearts, indicating that enzymatic estimates of infarct size correlate
closely with anatomic measurements. The results indicate that CK estimates
of myocardial infarct size represent a valid clinical end point for
assessing myocardial infarct size, and the effect of therapy thereon, in
groups of treated and control patients.
ARTICLES
Comparison of enzymatic and anatomic estimates of myocardial infarct size in man
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