Does Low Total Creatine Kinase Rule Out Myocardial Infarction?

Abstract

Letters15 March 1992Does Low Total Creatine Kinase Rule Out Myocardial Infarction?Laura Bilodeau, MD, Lynne M. Preese, MBA, Fred S. Apple, PhDLaura Bilodeau, MDSearch for more papers by this author, Lynne M. Preese, MBASearch for more papers by this author, Fred S. Apple, PhDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-116-6-523_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors: Serial creatine kinase and creatine kinase-MB measurements with clinical history findings, physical examination findings, and electrocardiographic (ECG) changes are the standards for diagnosing acute myocardial infarction (1, 2). Whether creatine kinase-MB measurements should be quantified when total creatine kinase activity never rises above the upper limit of the normal range is unclear (3, 4). We wondered whether there truly was an upper limit of the normal range for creatine kinase-MB measurements and whether percent relative index (creatine kinase-MB mass concentration/ total creatine kinase activity) might misdiagnose acute myocardial infarction when the total creatine kinase activity is normal....