Elevated Creatine Kinase MB Isoenzyme Research Articles

Children with coronavirus disease 2019: A review of demographic, clinical, laboratory, and imaging features in pediatric patients.

There is a current outbreak of coronavirus disease 2019 (COVID‐19), with a global spread. With the rapid increase in the number of infections, an increase is observed in the number of children with COVID‐19. Most research findings are regarding adult cases, which are not always transferrable to children. Evidence‐based studies are still expected to formulate clinical decisions for pediatric patients. In this review, we included 2597 pediatric patients that reported recently and evaluated the demographic, clinical, laboratory, and imaging features of children with COVID‐19. We found that even lymphopenia was the most common lab finding in adults; it infrequently occurred in children (9.8%). Moreover, elevated creatine kinase MB isoenzyme was much more commonly observed in children (27.0%) than that in adults, suggesting that heart injury would be more likely to occur in pediatric patients. Our analysis may contribute to determine the spectrum of disease in children and to develop strategies to control the disease transmission.

Using troponin T to diagnose acute coronary syndromes.

Elevated troponin T is a useful marker for acute myocardial infarction: it is more specific than is elevated creatine kinase MB isoenzyme, and it remains elevated for many days after creatine kinase levels have returned to normal, providing a useful indicator for late presentations. Nevertheless, creatine kinase MB still has many important roles, including providing estimates of infarct size and diagnosing acute myocardial infarction in patients with renal failure. Often, measuring both markers provides additional information. This article provides a diagnostic algorithm for using both markers.

Pulmonary Edema Associated With Subarachnoid Hemorrhage

A 56-year-old woman with no history of cardiac disease developed acute pulmonary edema following a subarachnoid hemorrhage. A constellation of findings, including elevated creatine kinase MB isoenzyme activity in the absence of electrocardiographic or scintigraphic evidence of acute myocardial infarction, elevated pulmonary artery wedge pressure, segmental wall motion abnormalities, and depressed ejection fraction of the left ventricle demonstrated by two-dimensional echocardiography and radionuclear ventriculography, pointed to a direct myocardial injury leading to cardiac failure. The evidence for cardiogenic origin of pulmonary edema provided by this case is in contrast to the belief that "neurogenic" pulmonary edema is of noncardiac origin.

Elevated Creatine Kinase MB Isoenzyme Levels in Marathon Runners

Elevated serum creatine kinase MB isoenzyme (CK-MB) levels are regarded as a sensitive and specific marker for myocardial injury. Serum CK-MB was measured in male marathon runners during training and after competition. Mean serum CK-MB measured by a quantitative electrophoretic technique (normal, less than 5 IU/L) showed borderline elevation during training with peaks 24 hours after competition. Mean CK-MB in 64 serum samples from 35 runners after competition was 130 IU/L or 8.3% of total CK activity. Levels of CK-MB averaging 26 times the upper limits of normal would usually be considered indicative of massive myocardial necrosis. Myocardial scintigraphy with technetium Tc 99m pyrophosphate was performed after competition in 12 randomly selected runners with a mean postrace serum CK-MB level of 160 IU/L or 13%. Infarct-avid ("hot-spot") scintigraphy, appropriately timed to detect underlying myocardial abnormalities, was within normal limits in all subjects. Normal results of infarct-avid scintigraphy coincident with marked serum CK-MB elevations strongly suggests that CK-MB arises from a noncardiac or skeletal muscle source in these runners.

Elevated creatine kinase MB isoenzyme levels in marathon runners. Normal myocardial scintigrams suggest noncardiac source

Elevated serum creatine kinase MB isoenzyme (CK-MB) levels are regarded as a sensitive and specific marker for myocardial injury. Serum CK-MB was measured in male marathon runners during training and after competition. Mean serum CK-MB measured by a quantitative electrophoretic technique (normal, &lt;5 IU/L) showed borderline elevation during training with peaks 24 hours after competition. Mean CK-MB in 64 serum samples from 35 runners after competition was 130 IU/L or 8.3% of total CK activity. Levels of CK-MB averaging 26 times the upper limits of normal would usually be considered indicative of massive myocardial necrosis. Myocardial scintigraphy with technetium Tc 99m pyrophosphate was performed after competition in 12 randomly selected runners with a mean postrace serum CK-MB level of 160 IU/L or 13%. Infarct-avid ("hot-spot") scintigraphy, appropriately timed to detect underlying myocardial abnormalities, was within normal limits in all subjects. Normal results of infarct-avid scintigraphy coincident with marked serum CK-MB elevations strongly suggests that CK-MB arises from a noncardiac or skeletal muscle source in these runners. (<i>JAMA</i>1981;246:2049-2051)