Fioretti P, Sclavo M, Brower R W, Simoons M L, Hugenholtz P G
Eur Heart J. 1985 Jun;6(6):473-8. doi: 10.1093/oxfordjournals.eurheartj.a061892.
The extent to which patients with low peak serum creatine kinase (CK) at their first myocardial infarction differ from patients with high CK levels in terms of risk for subsequent ischaemic events was investigated in 266 patients who survived the first 48 h from the onset of infarction. All patients were followed up for one year. Four groups were formed based on peak CK less than or equal to 200, 201-400, 401-800 and greater than 800 IU l-1. During follow-up the incidence of mortality was 15% (N = 39), non-fatal re-infarction 9% (N = 23), and angina 53% (N = 140). Hospital mortality was significantly higher (P less than 0.02) in the highest CK-group (16%), but the incidence of non-fatal re-infarction, angina pectoris and late mortality was similar in the four groups. In hospital survivors, ischaemic ST-changes during pre-discharge symptom limited bicycle stress test and multiple vessel disease were equally distributed in all four groups. We conclude that while hospital mortality is directly related to peak CK, there is no relationship between peak CK and late mortality, non-fatal re-infarctions, or recurrent angina. Accordingly, diagnostic and therapeutic procedures in the individual patients are not influenced by the amount of serum CK released during acute infarction.
在266例自梗死发作起存活48小时以上的患者中，研究了首次心肌梗死时血清肌酸激酶（CK）峰值较低的患者与CK水平较高的患者在后续缺血性事件风险方面的差异。所有患者均随访一年。根据CK峰值小于或等于200、201 - 400、401 - 800和大于800 IU l-1分为四组。随访期间，死亡率为15%（N = 39），非致命性再梗死为9%（N = 23），心绞痛为53%（N = 140）。最高CK组的医院死亡率显著更高（P < 0.02）（16%），但四组中非致命性再梗死、心绞痛和晚期死亡率的发生率相似。在住院幸存者中，出院前症状限制性踏车运动试验期间的缺血性ST段改变和多支血管病变在所有四组中分布相同。我们得出结论，虽然医院死亡率与CK峰值直接相关，但CK峰值与晚期死亡率、非致命性再梗死或复发性心绞痛之间没有关系。因此，个体患者的诊断和治疗程序不受急性梗死期间释放的血清CK量的影响。
