Stanisławska J, Opolski G, Słomka K, Niemczyk M, Górecki A, Tadeusiak W, Kraska T
Kliniki Kardiologii Instytutu Chorób Wewnetrznych AM, Warszawie.
Pol Arch Med Wewn. 1992 Nov;88(5):336-40.
111 patients below 70 years old, with the first acute myocardial infarctions, 6 hours since the pain occurred--have been treated with streptokinase i.v. In 102 patients we obtained full curve of CK-MB activity. Early peak of CK-MB activity < 15 hours after onset of symptoms we have observed in 59 patients, and late peak of CK-MB activity > 15 hours in 43 patients. There was not any significant statistics differences between early and late groups in frequency of: early ventricular fibrillation (< 48 hours), complex ventricular arrhythmia (in 21 day), heart failure and in-hospital mortality. 1 patient died in hospital in early group and in late group also died 1 patient. The follow-up period was from 10 to 48 months (av. 26 +/- 13). 100 patients left the hospital and the full informations we have obtained in 97 cases. No one died in that time. In the group with early peak CK-MB activity we observed more often the unstable angina and the new myocardial infarction (21%) than in the group with late peak of CK-MB activity (15%), but these differences were nonsignificant. In conclusion our results don't confirm that the early peak of CK-MB activity is the positive risk factor of unstable angina and the new myocardial infarction.
111例70岁以下首次发生急性心肌梗死、疼痛发作后6小时的患者接受了静脉注射链激酶治疗。102例患者获得了肌酸激酶同工酶(CK-MB)活性的完整曲线。我们观察到,59例患者的CK-MB活性在症状出现后15小时内出现早期峰值,43例患者的CK-MB活性在15小时后出现晚期峰值。早期和晚期组在以下方面的发生率无显著统计学差异:早期室颤(<48小时)、复杂性室性心律失常(21天内)、心力衰竭和住院死亡率。早期组有1例患者在住院期间死亡,晚期组也有1例患者死亡。随访期为10至48个月(平均26±13个月)。100例患者出院,我们获得了97例患者的完整信息。在此期间无人死亡。与CK-MB活性晚期峰值组(15%)相比,CK-MB活性早期峰值组中不稳定型心绞痛和新发心肌梗死的发生率更高(21%),但这些差异无统计学意义。总之,我们的结果并未证实CK-MB活性早期峰值是不稳定型心绞痛和新发心肌梗死的阳性危险因素。