|dc.contributor.author||Every, Nathan R.||en_US
|dc.identifier.citation||Turer A, Mahaffey K, Gallup D, et al. Enzyme estimates of infarct size correlate with functional and clinical outcomes in the setting of ST-segment elevation myocardial infarction. Current Controlled Trials in Cardiovascular Medicine. 2005;6(1):12.||en_US
|dc.description.abstract||Background: Cardiac biomarkers are routinely obtained in the setting of suspected myocardial
ischemia and infarction. Evidence suggests these markers may correlate with functional and clinical
outcomes, but the strength of this correlation is unclear. The relationship between enzyme
measures of myocardial necrosis and left ventricular performance and adverse clinical outcomes
Methods: Creatine kinase (CK) and CK-MB data were analyzed, as were left ventricular ejection
fraction (LVEF) by angiogram, and infarct size by single-photon emission computed tomography
(SPECT) imaging in patients in 2 trials: Prompt Reperfusion In Myocardial-infarction Evolution
(PRIME), and Efegatran and Streptokinase to Canalize Arteries Like Accelerated Tissue
plasminogen activator (ESCALAT). Both trials evaluated efegatran combined with thrombolysis for
treating acute ST-segment elevation myocardial infarction (STEMI).
Results: Peak CK and CK area-under-the-curve (AUC) correlated significantly with SPECTdetermined
infarct size 5 to 10 days after enrollment. Peak CK had a statistically significant
correlation with LVEF, but CK-AUC and LVEF correlation were less robust. Statistically significant
correlations exist between SPECT-determined infarct size and peak CK-MB and CK-MB AUC.
However, there was no correlation with LVEF for peak CK-MB and CK-MB AUC. The combined
outcome of congestive heart failure and death were significantly associated with CK AUC, CK-MB
AUC, peak CK, and peak CK-MB measurements.
Conclusion: Peak CK and CK-MB values and AUC calculations have significant correlation with
functional outcomes (LVEF- and SPECT-determined infarct size) and death or CHF outcomes in
the setting of STEMI. Cardiac biomarkers provide prognostic information and may serve as valid
endpoint measurements for phase II clinical trials.||en_US
|dc.title||Enzyme estimates of infarct size correlate with functional and clinical outcomes in the setting of ST-segment elevation myocardial infarction||en_US