In a study taking time from streptokinase infusion to peak CPK as a criterion for reperfusion, it was found that peaking of CPK occurred at 9.7 [+ or -] 6.3 and 12.3 [+ or -] 4.8 hours in those receiving 7.5 lakh units and 1.5 million units of streptokinase, respectively (difference not statistically significant) [Gottlich et al].14 In this study, in the group receiving, 7, 50, 000 IU of streptokinase, 89%) patients showed peaking of CPK-MB
within 12 hours, while 67% of patients did so in the group given 1.500, 000 IU.
Peri-operative MI was defined as the occurrence of new Q waves in the ECG or peak CPK-MB
levels five times or more than the upper limit.
Laboratory examinations revealed the following: total creatine phosphokinase (CPK), 136 U/L (reference range: 0-171 U/L); CPK-MB
, 21.0 ng/ml (reference range: 2.0-7.2 ng/ml); myoglobin, 488 ng/ml (reference range: 23-112 ng/ml); B-type natriuretic peptide, 4080 pg/ml (reference range: 300-900 pg/ml); and troponin I, 0.680 ng/ml (reference range: 0.010-0.023 ng/ml).
Troponin I, CPK-MB
, hs-CRP, CBC, and ESR were assessed from the same sample.
 Cardiac biomarkers such as troponin T/I (>0.1 ng/mL), and creatinine phosphokinase isoenzyme-MB fraction (CPK-MB
) are elevated in many cases.
[6,7] studied biochemical ischemic markers and showed that more enzymes (CPK, CPK-MB
, catalase, troponin-I) were released in animals that underwent bypassing that involved clamping of coronary arteries.
Creatine phosphokinase (CPK) and CPK-MB
levels were measured by enzymatic methods (Dimension[R]; Siemens, Healthcare Diagnostics Inc.), cortisol levels were determined using a chemiluminescent enzyme immunoassay (Immulite[R]; Siemens, Healthcare Diagnostics Inc.), and glucose levels were measured by a biochromatic method (Dimension[R]; Siemens, Healthcare Diagnostics Inc.).
Creatine Phosphokinase-MB (CPK-MB
) and the Diagnosis of Myocardial Infarction.
Her serum levels of creatine kinase (CPK) and CPK-MB
, and troponin-l remained within normal limits.