CREATINE-KINASE SUBFORM ANALYSIS IN HEMODIALYSIS-PATIENTS WITHOUT ACUTE CORONARY SYNDROMES

isoenzyme (CK MB) in the blood of patients with acute chest pain syndr omes is a key factor in making the diagnosis of acute myocardial infar ction. With of elevated levels of creatine kinase (CK) and its myocard ial the widespread use of thrombolytic therapy and emergency angioplas ty, the ability to make a rapid and accurate diagnosis of myocardial i nfarction is critical. A ne iv rapid method for analysis of the subfor ms of the MB isoenzyme has been shown to be sensitive and specific for the diagnosis of myocardial infarction in the general population, Bec ause of its rapidity it has been replacing standard analyses of total CK and CK MB in some centers in guiding the initial therapy of patient s with chest pain. Levels of CK MB can be abnormally elevated in hemod ialysis patients even in the absence of acute myocardial necrosis, Thi s study was undertaken in order to determine if subform analysis of th e MB isoenzyme could similarly be abnormal in hemodialysis patients wi thout acute coronary syndromes, CK MB subforms were analyzed in 52 pat ients without any recent cardiac symptoms who came into the dialysis u nit For a routine hemodialysis treatment, We then applied the same cri teria for the diagnosis of an acute myocardial infarction as would be used clinically. In this population, the subform analysis was surprisi ngly consistent with myocardial infarction in approximately 29% of the patients. Thus, subform analysis appears likely to result in an erron eous diagnosis of acute myocardial infarction in patients on hemodialy sis.