Shahid Hafeez.
Early peaking of CK-MB fraction - An effective clinical indicator of successful Coronary Thrombolysis.
J Coll Physicians Surg Pak Jan ;12(11):682-5.

Objective: To determine the significance of serial analysis of CK-MB fraction in the detection of effective coronary thrombolysis. Design: A prospective interventional study. Place and Duration of Study: The study was carried out in the Department of Medicine at CMH Quetta from September, 1998 to February, 1999. Subjects and Methods: Twenty-five patients of acute myocardial infarction, presenting within 12 hours of onset of chest pain, were selected and given streptokinase. The baseline clinical and laboratory parameters were recorded. Serial blood samples were collected at 30, 60, 90 and 120 minutes after initiation of therapy (0 minutes) and then after every 2 hours for next 12 hours to observe the release profile of CK-MB after streptokinase infusion. The patients were observed for signs of reperfusion by monitoring relief of chest pain, resolution of ST segment elevation and early peaking of CK-MB fraction. They were divided into two groups. Reperfusion group (n = 18) which showed clinical signs of reperfusion i.e. relief of chest pain and resolution of ST segment elevation and Control group (n = 7) which did not show any clinical sign of reperfusion. Results: The release profile of CK-MB for patients in reperfusion group was different from those in control group. There was definite early peaking {Mean (range) time 2.58(0.5-4) hrs vs 5.27 (3.5-8.1) hrs} in the patients of reperfusion group as compared to those in the control group. Conclusion: The study suggests that early peaking (wash out) of CK-MB fraction after thrombolytic therapy reliably indicates effective coronary thrombolysis especially when considered in conjunction with other clinical parameters i.e. relief of chest pain and resolution of ST segment elevation.

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