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Serum CK-MB in Diagnosis and Assessment of Acute Myocardial Infarction

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Acute Coronary Care

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Abstract

When coronary care units were first developed in the early 1960s, it became important to make a prompt diagnosis regarding presence or absence of an acute myocardial infarct (AMI) to optimize the use of these specialized facilities. This diagnosis was extremely difficult when no new Q waves appeared on the electrocardiogram (ECG) during the first 24–48 h following CCU admission. Total “cardiac” enzyme determinations were an alternative, and when glutamic oxaloacetic transaminase (SGOT), lactic dehydrogenase (LDH), and creatine kinase (CK) all remained within normal limits, the diagnosis of an acute infarct was excluded. However, a variety of other body tissues could be the source of transient elevations of each of these enzymes. The first attempt to specifically identify the tissue of origin of an enzyme was the electrophoretic method for separating the isoenzymes of LDH [1]. This improvement over the use of total LDH was still suboptimal, because (a) an elevation in LDH1 could result from hemolysis as well as from myocardial necrosis, and (b) the results were expressed as ratios of one isoenzyme (LDH1) to another (LDH2) rather than the absolute level of a particular isoenzyme.

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Authors
  1. Richard D. White
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  2. Peer Grande
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  3. Galen S. Wagner
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Editor information

Editors and Affiliations

  1. Department of Medicine, Duke University Medical Center, Box 31123, 27710, Durham, North Carolina, USA

    Robert M. Califf M.D.

  2. Department of Medicine, Duke University Medical Center, Box 31211, 27710, Durham, North Carolina, USA

    Galen S. Wagner M.D.

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© 1985 Martinus Nijhoff Publishing, Boston/Dordrecht/Lancaster

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White, R.D., Grande, P., Wagner, G.S. (1985). Serum CK-MB in Diagnosis and Assessment of Acute Myocardial Infarction. In: Califf, R.M., Wagner, G.S. (eds) Acute Coronary Care. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-3828-4_18

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  • DOI: https://doi.org/10.1007/978-1-4613-3828-4_18

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-3830-7

  • Online ISBN: 978-1-4613-3828-4

  • eBook Packages: Springer Book Archive

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