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Relationship Between Onset of Symptoms of Infarction and Appearance and Disappearance of Enzyme

Robert G. Irvin, MD; Frederick R. Cobb, MD; Charles R. Roe, MD

Arch Intern Med. 1980;140(3):329-334.

Abstract
• Sixty-six patients admitted to the coronary care unit within 12 hours of the onset of symptoms of acute myocardial infarction (AMI) were subjected to blood sampling at one- to two-hour intervals for analysis of creatine phosphokinase (CPK) and lactic dehydrogenase (LDH) enzymes and isoenzymes. Complete MB CPK curves were obtained in 27 patients, and these were analyzed for optimum times for sampling and minimum number of analyses for detection of AMI. The present study indicates that (1) optimum detection of AMI can be achieved by analysis for MB CPK in a minimum of two samples obtained at 12 and 24 hours after onset of symptoms of AMI; (2) negative results of analyses for MB CPK in samples obtained before 12 hours or after 24 hours should not be used to exclude the diagnosis of AMI; and (3) a total CPK value within the normal range is not a reliable screening test to exclude analysis of MB CPK.

(Arch Intern Med 140:329-334, 1980)

Author Affiliations
From the Departments of Medicine (Drs Irvin and Cobb) and Pediatrics (Dr Roe), Duke University Medical Center, and the Durham Veterans Administration Medical Center (Drs Irvin and Cobb), Durham, NC.

Footnotes
Accepted for publication June 11, 1979.

Reprint requests to Department of Medicine, Veterans Administration Medical Center, 508 Fulton St, Durham, NC 27705 (Dr Cobb).

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