The combination of creatine kinase-myocardial band isoenzyme and point-of-care cardiac troponin/contemporary cardiac troponin for the early diagnosis of acute myocardial infarction

BACKGROUND:The early diagnosis of acute myocardial infarction(AMI)remains challenging,especially for institutions without the high-sensitive cardiac troponin(hs-c Tn)assay.Herein,we aim to assess the value of creatine kinase-myocardial band isoenzyme(CK-MB)combined with different cardiac troponin(c Tn)assays in AMI diagnosis.METHODS:This multicenter,observational study included 3,706 patients with acute chest pain from September 1,2015,to September 30,2017.We classified the participants into three groups according to the c Tn assays:the point-of-care c Tn(POC-c Tn)group,the contemporary c Tn(c-c Tn)group,and hs-c Tn group.The diagnostic value was quantified using sensitivity and the area under the curve(AUC).RESULTS:Compared to the single POC-c Tn/c-c Tn assays,combining CK-MB and POC-c Tn/c-c Tn increased the diagnostic sensitivity of AMI(56.1%vs.63.9%,P<0.001;82.7%vs.84.3%,P=0.025).In contrast,combining CK-MB and hs-c Tn did not change the sensitivity compared with hs-c Tn alone(95.0%vs.95.0%,P>0.999).In the subgroup analysis,the sensitivity of combining CKMB and c-c Tn increased with time from symptom onset<6 h compared with c-c Tn alone(72.8%vs.75.0%,P=0.046),while the sensitivity did not increase with time from symptom onset>6 h(97.5%vs.98.3%,P=0.317).The AUC of the combination of CK-MB and POC-c Tn significantly increased compared to the single POC-c Tn assay(0.776 vs.0.750,P=0.002).The AUC of the combined CKMB and c-c Tn/hs-c Tn assays did not significantly decrease compared with that of the single c-c Tn/hs-c Tn assays within 6 h.CONCLUSIONS:The combination of CK-MB and POC-c Tn or c-c Tn may be valuable for the early diagnosis of AMI,especially when hs-c Tn is not available.

Dietary glycine supplementation enhances syntheses of creatine and glutathione by tissues of hybrid striped bass(Morone saxatilis ♀ × Morone chrysops ♂) fed soybean meal-based diets

Background We recently reported that supplementing glycine to soybean meal-based diets is necessary for the optimum growth of 5-to 40-g(Phase-I)and 110-to 240-g(Phase-II)hybrid striped bass(HSB),as well as their intestinal health.Although glycine serves as an essential substrate for syntheses of creatine and glutathione(GSH)in mammals(e.g.,pigs),little is known about these metabolic pathways or their nutritional regulation in fish.This study tested the hypothesis that glycine supplementation enhances the activities of creatine-and GSH-forming enzymes as well as creatine and GSH availabilities in tissues of hybrid striped bass(HSB;Morone saxatilis♀×Morone chrysops♂).Methods Phase-I and Phase-II HSB were fed a soybean meal-based diet supplemented with 0%,1%,or 2%glycine for 8 weeks.At the end of the 56-d feeding,tissues(liver,intestine,skeletal muscle,kidneys,and pancreas)were collected for biochemical analyses.Results In contrast to terrestrial mammals and birds,creatine synthesis occurred primarily in skeletal muscle from all HSB.The liver was most active in GSH synthesis among the HSB tissues studied.In Phase-I HSB,supplementation with 1%or 2%glycine increased(P<0.05)concentrations of intramuscular creatine(15%–19%)and hepatic GSH(8%–11%),while reducing(P<0.05)hepatic GSH sulfide(GSSG)/GSH ratios by 14%–15%,compared with the 0-glycine group;there were no differences(P>0.05)in these variables between the 1%and 2%glycine groups.In Phase-II HSB,supplementation with 1%and 2%glycine increased(P<0.05)concentrations of creatine and GSH in the muscle(15%–27%)and liver(11%–20%)in a dose-dependent manner,with reduced ratios of hepatic GSSG/GSH in the 1%or 2%glycine group.In all HSB,supplementation with 1%and 2%glycine dose-dependently increased(P<0.05)activities of intramuscular arginine:glycine amidinotransferase(22%–41%)and hepaticγ-glutamylcysteine synthetase(17%–37%),with elevated activities of intramuscular guanidinoacetate methyltransferase and hepatic GSH synthetase and GSH reductase in the 1%or 2%glycine group.Glycine supplementation also increased(P<0.05)concentrations of creatine and activities of its synthetic enzymes in tail kidneys and pancreas,and concentrations of GSH and activities of its synthetic enzymes in the proximal intestine.Conclusions Skeletal muscle and liver are the major organs for creatine and GSH syntheses in HSB,respectively.Dietary glycine intake regulates creatine and GSH syntheses by both Phase-I and Phase-II HSB in a tissue-specific manner.Based on the metabolic data,glycine is a conditionally essential amino acid for the growing fish.

Detection of LAMA2 c.715C>G:p.R239G mutation in a newborn with raised creatine kinase: A case report

BACKGROUND We report a rare case of primary clinical presentation featuring elevated creatine kinase(CK)levels in a neonate,which is associated with the LAMA2 gene.In this case,a heterozygous mutation in exon5 of the LAMA2 gene,c.715C>G(resulting in a change of nucleotide number 715 in the coding region from cytosine to gua-nine),induced an amino acid alteration p.R239G(No.239)in the patient,repre-senting a missense mutation.This observation may be elucidated by the neonatal creatine monitoring mechanism,a phenomenon not previously reported.CASE SUMMARY We analysed the case of a neonate presenting solely with elevated CK levels who was eventually discharged after supportive treatment.The chief complaint was identification of increased CK levels for 15 d and higher CK values for 1 d.Ad-mission occurred at 18 d of age,and despite prolonged treatment with creatine and vitamin C,the elevated CK levels showed limited improvement.Whole exo-me sequencing revealed the presence of a c.715C>G mutation in LAMA2 in the newborn,correlating with a clinical phenotype.However,the available informa-tion offers insufficient evidence for clinical pathogenicity.CONCLUSION Mutations in LAMA2 are associated with the clinical phenotype of increased neonatal CK levels,for which no specific treatment exists.Whole genome sequen-cing facilitates early diagnosis.

Prognostic implications of creatine kinase-MB elevation after percutaneous coronary intervention results from the evaluation of drug-eluting stents and ischemic events (EVENT) registry

Background Creatine kinase-MB （CK-MB） elevation after been associated with increased risk for mortality. Although most infarction （pMI） as an elevation in CK-MB 〉 3 × upper limit of and variation in site-specific definitions of the ULN may limit the percutaneous coronary intervention （PCI） has studies have defined periprocedural myocardial normal （ULN）, use of different CK-MB assays value of such relative thresholds.

(Phospho)creatine:the reserve and merry-go-round of brain energetics

Creatine transporter(CrT)-deficiency,the most common form of the cerebral creatine deficiency syndromes,causes cognition impairments and severe reduction of the brain creatine(Cr)and phosphocreatine(PCr)levels,and responds poorly to oral Cr supplement as a treatment option.The ca uses of cognitive impairments in CrT-deficient children remain unclear.We recently use gene-targeting to create a mouse model of CrT-deficiency to assess the impacts of Cr/PCr deficiency on brain energetics and stress-adaptation responses(Chen et al.,2021).

Creatine Pyruvate Enhances Lipolysis and Protein Synthesis in Broiler Chicken

To assess the effects ofcreatine pyruvate （Cr-Pyr） on lipid and protein metabolism in broiler chickens, a total of 400 1-day-old male birds （Aconred） were randomly allocated to four groups, with each group replicating four times and each replicate involving 25 birds. The broilers were provided with a commercial diet supplemented with Cr-Pyr at 0, 1, 5, or 10% of the diet, respectively, for a period of 3 wk ad libitum （from 22 to 42 d）. In the present study, body weight （BW） and average daily gain （ADG） of broilers decreased in 10% Cr-Pyr group （P〈0.01）, whereas the relative leg and pectoral muscle weights were significantly higher than they were in the control group （P〈0.05）. 5 or 10% Cr-Pyr of diets decreased the abdominal fat rate （AFR, abdominal fat/live weight） of the broilers. The serum or hepatic triglyceride （TG） concentrations were significantly lower in the 5 and 10% groups （P〈0.01）. In contrast, Cr-Pyr caused a marked increase in the serum nonesterified fatty acid （NEFA）, high-density lipoprotein cholesterol （HDL-C） and creatine kinase （CK） concentrations （P〈0.01）. Supplementation with Cr-Pyr （5 and 10%） in the diet also increased glucagons （GLU）, insulin （INS） or leptin （LEP） contents （P〈0.01）. The expression of hepatic peroxisomal proliferators-activated receptor α （PPAR-α） and carnitine palmitoyl transferase-I （CPT-I）, muscle insulin-like growth factor I （IGF-I） were significantly elevated and myostatin mRNA level was reduced in the 5 and 10% groups （P〈0.05）. It was found that supplementation with 5% Cr-Pyr improves both lipid and protein metabolism by regulating various metabolic parameters of broilers, while not adversely affects growth performance in broiler chickens.

American ginseng supplementation attenuates creatine kinase level induced by submaximal exercise in human beings

AIM: To investigate whether American ginseng (AG, Panax quinquefolium) supplementation was able to improve endurance exercise performance.METHODS: Thirteen physically active male college students were divided into two groups (AG or placebo)and received supplementation for 4 wk, before the exhaustive running exercise. Treadmill speed was increased to a pace equivalent to 80% VO2max of the subject. A 4-wk washout period followed before the subjects crossed over and received the alternate supplement for the next 4 wk.They then completed a second exhaustive running exercise. The physiological variables that were examined included time to exhaustion and oxygen pulse. Moreover,the plasma creatine kinase (CK) and lactate were measured prior to the exercise, at 15 and 30 min during exercise,immediately after exercise, and 20, 40, 60, and 120 min after exercise.RESULTS: The major finding of this investigation was that the production plasma CK during the exercise significantly decreased for group AG than for group P. Secondary physiological finding was that 80% VO2max running was not improved over a 4-wk AG supplementation regimen.CONCLUSION: Supplementation with AG for 4 wk prior to an exhaustive aerobic treadmill running reduced the leakage of CK during exercise, but did not enhance aerobic work capacity. The reduction of plasma CK may be due to the fact that AG is effective for the decrease of skeletal muscle cell membrane damage, induced by exercise during the high-intensity treadmill run.

Oral creatine supplementation:A potential adjunct therapy for rheumatoid arthritis patients

Creatine is one of the most popular forms of protein supplements and is known to improve performance in healthy athletic populations via enhanced muscle mass and adenosine triphosphate energy regeneration.Clinical use of creatine may similarly benefit patients with rheumatoid arthritis(RA), an inflammatory condition characterised by generalised muscle loss termed"rheumatoid cachexia". The adverse consequences of rheumatoid cachexia include reduced strength, physical function and, as a consequence, quality of life.Whilst regular high-intensity exercise training has been shown to increase muscle mass and restore function in RA patients, this form of therapy has very low uptake amongst RA patients. Thus, acceptable alternatives are required. The aim of this review is to consider the potential efficacy of creatine as an anabolic and ergonomic therapy for RA patients. To date, only one study has supplemented RA patients with creatine, and the findings from this investigation were inconclusive. However, trials in populations with similar losses of muscle mass and function as RA, including older adults andthose with other muscle wasting conditions, indicate that creatine is an efficacious way of improving muscle mass, strength and physical function, and may offer an easy, safe and cheap means of treating rheumatoid cachexia and its consequences.

Creatine kinase in the diagnosis and prognostic prediction of amyotrophic lateral sclerosis:a retrospective case-control study

Creatine kinase is a muscle enzyme that has been reported at various levels in different studies involving patients with amyotrophic lateral sclerosis.In the present retrospective case-control study,we included 582 patients with amyotrophic lateral sclerosis and 582 age-and sexmatched healthy controls.All amyotrophic lateral sclerosis participants received treatment in the Department of Neurology,West China Hospital,China,between May 2008 and December 2018.Serum creatine kinase levels in patients with amyotrophic lateral sclerosis were significantly higher than those in healthy controls.Subgroup analysis revealed that serum creatine kinase levels in men were higher than those in women in both amyotrophic lateral sclerosis patients and healthy controls.Compared with patients with bulbar-onset amyotrophic lateral sclerosis,patients with limb-onset amyotrophic lateral sclerosis had higher creatine kinase levels.Spearman's correlation analysis revealed that serum creatine kinase levels were not correlated with body mass index,Amyotrophic lateral Sclerosis Functional Rating ScaleRevised score,or progression rate.After adjusting for prognostic covariates,higher log creatine kinase values were correlated with higher overall survival in the amyotrophic lateral sclerosis patients.We also investigated the longitudinal changes in serum creatine kinase levels in 81 amyotrophic lateral sclerosis patients;serum creatine kinase levels were decreased at the second blood test,which was sampled at least 6 months after the first blood test.Together,our results suggest that serum creatine kinase levels can be used as an independent factor for predicting the prognosis of amyotrophic lateral sclerosis patients.This study received ethical approval from the Ethics Committee of West China Hospital,China(approval No.2015(236))on December 23,2015.

Effect of creatine phosphate sodium on miRNA378,miRNA378＊ and calumenin mRNA in adriamycin-injured cardiomyocytes

Objective: To investigate the effect of creatine phosphate sodium(sodium phosphocreatine) on miRNA378, miRNA378* and calumenin m RNA in adriamycin-injured suckling mouse myocardium. Methods: The suckling mouse myocardium of primary culture were randomly divided into control group, adriamycin group and treatment group. To identify the suckling mouse myocardium, Smooth muscle actin-α(α-SMA) was monitored by immunohistochemical method. Cardiac function was evaluated by transthoracic echocardiography. The mRNA change of miRNA378, miRNA378* and calumenin m RNA were detected by quantitative real-time PCR. The expression of calumenin and GRP78 were identified by western blot. Results: Mitochondrial damage and vacuolization were found in adriamycin-induced suckling mouse myocardium compared with control group, while creatine phosphate sodium could reduce this phenomenon. Compared with the control group, the mRNA of miRNA378, miRNA378* and calumenin in adriamycin group was reduced, while creatine phosphate sodium could increase this phenomenon. The expression of calumenin and GRP78 were decreased after adriamycin treatment in suckling mouse myocardiums, creatine phosphate sodium increased the expression of calumenin and GRP78. Conclusion: The results of this experiment might be closely related to the effects of that creatine phosphate sodium reduced the pathological mechanism of suckling mouse myocardium with myocarditis caused by adriamycin.

Oligosaccharide and Creatine Supplementation on Glucose and Urea Nitrogen in Blood and Serum Creatine Kinase in Basketball Athletes

Summary： The effects of oligosaccharide and creatine （Cr） supplementation on glucose, lactic acid and urea nitrogen levels in blood and activity of serum creatine kinase （CK） were explored. Twenty CUBA male athletes were divided into 4 groups： group A （supplementation of Cr alone）, group B （supplementation of oligosaccharide）, group C （supplementation of oligosaccharide and Cr） and group D （placebo control group）. By using orthogonal L4 table （2a ）, the experiment was performed. There were factors including oligosaccharide （carbohydrate, CHO）, Cr and their correlation. Each factor had two levels： supplementation and no-supplementation. The results showed that the supplementation of CliO or Cr alone, combined supplementation of CHO and Cr could significantly reduce the glucose, urea nitrogen levels in blood and serum CK activity after competition in the athletes. Moreover, the effects of combined supplementation of CHO and Cr were more satisfactory. It was concluded that supplementation of CliO and Cr could promote the recovery of physical performance and athletic abilities after athletics in basketball athletes.

Flunarizine and lamotrigine prophylaxis effects on neuron-specific enolase, S-100, and brain-specific creatine kinase in a fetal rat model of hypoxic-ischemic brain damage

BACKGROUND： Calcium antagonists may act as neuroprotectants, diminishing the influx of calcium ions through voltage-sensitive calcium channels. When administered prophylactically, they display neuroprotective effects against hypoxic-ischemic brain damage in newborn rats. OBJECTIVE： To investigate the neuroprotective effects of flunarizine （FNZ）, lamotrigine （LTG） and the combination of both drugs, on hypoxic-ischemic brain damage in fetal rats. DESIGN AND SETTING： This randomized, complete block design was performed at the Department of Pediatrics, Shenzhen Fourth People＇s Hospital, Guangdong Medical College. MATERIALS： Forty pregnant Wistar rats, at gestational day 20, were selected for the experiment and were randomly divided into FNZ, LTG, FNZ ＋ LTG, and model groups, with 10 rats in each group. METHODS： Rats in the FNZ, LTG, and FNZ ＋ LTG groups received intragastric injections of FNZ （0.5 mg/kg/d）, LTG （10 mg/kg/d）, and FNZ （0.5 mg/kg/d） ＋ LTG （10 mg/kg/d）, respectively. Drugs were administered once a day for 3 days prior to induction of hypoxia-ischemia. Rats in the model group were not administered any drugs. Three hours after the final administration, eight pregnant rats from each group underwent model establishment hypoxia-ischemia brain damage to the fetal rats. Cesareans were performed at 6, 12, 24, and 48 hours later; and 5 fetal rats were removed from each mother and kept warm. Two fetuses without model establishment were removed by planned cesarean at the same time and served as controls. A total of 0.3 mL serum was collected from fetal rats at 6, 12, 24, and 48 hours, respectively, following birth. MAIN OUTCOME MEASURES： Serum protein concentrations of neuron-specific enolase and S-100 were measured by ELISA. Serum concentrations of brain-specific creatine kinase were measured using an electrogenerated chemiluminescence method. RESULTS： Serum concentrations of neuron-specific enolase, S-100, and brain-specific creatine kinase were significantly higher in the hypoxic-ischemic fetal rats, compared with the non-hypoxic-ischemic group. Serum concentrations of neuron-specific enolase, S-100, and brain-specific creatine kinase were significantly less in the FNZ, LTG, and FNZ ＋ LTG groups following ischemia, compared with the model group （P 〈 0.01）. However, these values were significantly greater in the FNZ and LTG groups, compared with the FNZ ＋ LTG group, following ischemia （P 〈 0.01）. CONCLUSION： Preventive antenatal use of oral FNZ and LTG has positive neuroprotective effects on intrauterine hypoxic-ischemic brain damage. The combined effect of these two drugs is superior.

Creatine HCl and Creatine Monohydrate Improve Strength but Only Creatine HCl Induced Changes on Body Composition in Recreational Weightlifters

Background: Creatine supplementation is a subject that is very well studied. New forms of creatine are suggesting improvements in this supplement performance. Creatine HCl is supposed to have better solubility and absorption than creatine. The aim of this study was to compare the effects of two different doses of creatine HCl with creatine monohydrate on the strength and body composition in recreational weightlifters and to verify the relationship between strength and body composition. Methods: 40 subjects were divided in four groups: Creatine Monohydrate (CMG) 5 g/daily;Creatine HCl-1 (HCl-1) 5 g/daily, Creatine HCl-2 (HCl-2) 1.5 g/daily and Control group (CG) = 5 g of resistant starch/daily. All groups performed a resistance training program during 4 weeks. Body composition and strength were evaluated pre and post intervention. Results: The 1 RM at the Leg press was increased significantly in all groups (CMG: pre = 264.4 ± 83.8 × post = 298.1 ± 90.9;HCl-1: pre = 295.0 ± 88.3 × post = 338.3 ± 86.8 and HCl-2: pre = 274.3 ± 57.1 × post = 305.7 ± 59.4;p p = 0.003), however, there was no statistically significant difference between groups. Fatmass was significantly decreased in HCl-1 (pre = 14.5 ± 8.0 × post = 13.3 ± 8.3;p = 0.034) and HCl-2 (pre = 13.8 ± 5.8 × post = 12.7 ± 5.6;p = 0.005) but fat-free mass was increased only in HCl-1 (pre = 52.2 ± 8.9 × post = 53.8 ± 8.9;p = 0.031), with no differences between groups again. We observed strong correlations between upper limb strength and fat mass (r = 0.93, p p < 0.05) only in HCl-1 group. Conclusions: We concluded that creatine HCl and creatine Monohydrate improve performance but only creatine HCl induces changes on body composition in recreational weightlifters with differences between creatine HCl doses.

CREATINE,CARBS,AND FLUIDS:HOW IMPORTANT IN SOCCER NUTRITION?

KEY POINTS Because so much of the running in soccer is at less than maximal sprinting speed, creatine supplementation likely provides no benefit to match performance.Overwhelming evidence proves that a diet rich in carbohydrates can fill muscles with glycogen, and glycogen is critical to optimal performance in soccer. Soccer players’ diets, especially in the days before hard training or competition, should include 8-10 grams of carbohydrate per kilogram of body weight (3.5-4.5 g/lb). Cereals, fruits, vegetables, breads, and pastas are good sources ofcarbohydrates. Refueling of muscle with carbohydrates should begin as soon as possible following a match or a strenuous training session. Inadequate replacement of fluids lost in sweat can lead to poor soccer performance and heat illness. Players should aim to drink enough during training sessions and matches so that their body weights after play are within about 1 kg (2.2 lb) of their starting weights.  For a light workout or an easy match, especially when the weather is cool, water can be an adequate fluid replacement, if enough is ingested. But when play is strenuous and the weather is hot, carbohydrate-electrolyte sports drinks do a better job of maintaining body fluids.

RXPERIMENTAL AND CLINICAL STUDY OF CREATINE KINASE BB ACTIVITY FOR THE DIAGNOSIS ON BRAIN DAMAGE

Objective To study the differential diagnosis on cerebral concussion and mild cerebral contusion value of the brain type creatine kinase isoenzyme(CK BB),and evaluate the seriousness of brain damage and prognosis of the patients with acute head injury.Methods Chromatographic separating and fluorometric quantifying technique was used to detect the CK BB activity in the cerebrospinal fluid(CSF) of 117 patients with acute head injury and 12 patients with increased intracranial pressure and 20 normal people.Results The CSF CK BB activity of the patients with acute head injury was remarkably higher than that of the normal people and the CSF CK BB activity increased with the seriousness of brain damage.There was a close relationship between CSF CK BB activity and prognosis,and higher activity of CSF CK BB indicated poor prognosis.Conclusion CSF CK BB activity could be used as a new index to diagnose brain damage and evaluate the seriousness of brain damage and prognosis.

An Ion-Pair HPLC Method for Simultaneous Determination of Exogenous Phosphocreatine and Its Metabolite Creatine and Related ATP in Rabbit Plasma and RBC: Application to a Pharmacokinetic Study

A specific, precise and accurate ion-pair HPLC-UV method has been developed and validated for simultaneous determination of phosphocreatine (PCr), and its metabolite creatine (Cr) as well as related ATP in plasma and red blood cell (RBC) of rabbits. After addition of TMP as IS, the samples were deproteinized with 6% PCA. The analytes were separated on a Kromasil C18 column using a tertiary gradient mobile phase composed of buffer A (0.2% KH2PO4 + 0.08% tetrabutyl ammonium hydrogen sulphate, pH 3.0), buffer B (buffer A adjusted to pH 7.5 with 1 mol/L NaOH) and MeOH. Detection wavelengths were set at 210 nm for PCr and Cr and 260 nm for ATP and TMP. Some blank samples were initially run for baseline subtraction. The linear detection responses were obtained for PCr concentration over a range of 10 - 7500 mg/ml (plasma) and 5 - 2500 mg/ml (RBC) and for both Cr and ATP concentrations of 10 - 1500 mg/ml (plasma) and 5 - 750 mg/ml (RBC) (r > 0.99). The QC samples of 3 analytes showed intra-day and inter-day precisions (RSD) of - 107%. The method was successfully used to simultaneously determine plasma and RBC concentrations of the 3 analytes and to study pharmacokinetics after iv administration of PCr to rabbits.

Relationship Between Serum Creatine Kinase Isoenzyme MM Subbands and the Gradation of Coronary Stenosis in Patients with Unstable Angina Pectoris

Objective To observe the relationship between serum creatine kinase isoenzyme MM sub-bands (CKMM3/MM1 ratio) and the gradation of coronary stenosis and provide a simple, reliable, and economical method for identifying high-risk unstable angina pectoris (UAP). Mehtods Blood samples were drawn at different time after onset of chest pain in 21 patients with UAP and only once in 20 each volunteers for control. CKMM3/MM1 ratio was detected by nonserial buffer agarose gel electrophoresis. CKMB and CK were observed by velocity method. An emergent coronary arteriography was performed as soon as patients were admitted into hospital. Results Patients with UAP were divided into two subgroups: patients with elevated serum enzyme [P( + )] and patients with normal serum enzyme [P( - ) ] according to CKMM3/MM1 ratio < 0. 5. Patients with UAP( + ) had higher serum CKMM3/MM1 ratios from 0.5 to 12hrs and serum CKMB from 2 to 12 hrs than those with UAP( - ) and control ( P < 0. 05) . Serum enzyme concentrations of patients with UAP whose coronary lumen had 90% or more than 90% stenosis were significantly higher than those whose coronary lumen had less than 90% stenosis ( P <0. 01) . Any CK-MM3/MM1 ratio was less than 1. 0 and CK within the normal range in patients with UAP( + ) group. Conclusions CKMM3/MM1 ratios in patients with UAP can reflect severity of myocardial ischemia. SerumCKMM3/MM1 ratio provides a simple, reliable, and economical method for identifying high-risk UAP.

Influence of nicorandil combined with creatine phosphate sodium on serum cell factors and cardiac function in patients with STEMI

Objective: To observe the influence of nicorandil combined with creatine phosphate sodium on serum BNP, CK-MB, cTnl, SOD, MMP-9 and cardiac function in patients with STEMI. Methods: A total of 60 patients with STEMI were randomly divided into observation group (30 cases) and control group (30 cases). Observation group: nicorandil combined with creatine phosphate sodium;control group: patients were treated only by nicorandil. Recording and comparing the levels of BNP, CK-MB, cTnl, SOD, MMP-9 and cardiac function before and after treatment. Results: (1) Before treatment, there was no statistically significant difference in the serum BNP, CK-MB, cTnl, SOD, MMP-9 levels between the two groups. After treatment, compared with the same group before treatment, the serum BNP, CK-MB, cTnl, MMP-9 levels of the two groups were significantly lower, the serum SOD level of the two groups were significantly higher, and those levels of observation group were significantly better than the control group, there was significant difference between the two groups. (2) Before treatment, there was no statistically significant difference in LVEF, WMSI, CI between the two groups. After treatment, compared with the same group before treatment, the WMSI of the two groups were significantly lower, the LVEF and CI of the two groups were significantly higher, and those levels of observation group were significantly better than the control group, there was significant difference between the two groups. Conclusion: Nicorandil combined with creatine phosphate sodium for patients with STEMI can perfect the levels of serum BNP, CK-MB, cTnl, SOD, MMP-9 and be beneficial to protect their cardiac function.

The study of myocardial protective effect of creatine phosphate sodium in liver transplant patients

Objective:To study the cardioprotective effectof creatine phosphate sodium by measuring perioperative myocardial enzymes of allogeneic liver transplant patients.Methods:The 26 cases of orthotopic liver transplant patients were randomly divided into control group and creatine phosphate sodium group,13 cases in each group.The creatine phosphate sodium group were given creatine phosphate sodium 30 mg/kg at the time of induction.The control group were given equal amount of N.S.All patients at six-phase of before surgery,after anesthesia,before anhepatic phase,anhepatic phase,new liver and the 12 hours after surgery extraction radial artery.The CK,CK-MB and cTnI activity was measured.Results:To compared with control group,creatine phosphate sodium group’s plasma CK,CK-MB and cTnI concentrations in before anhepatic phase,anhepatic phase,new liver and the 12 hours after surgery 4 phase are significantly lower(p<0.05).Conclusions:The creatine phosphate sodium has a protective effect on liver transplantation in patients with myocardial damage.

Does Creatine Phosphokinase MB Predict Long-Term Cardiac Death or Atrial Fibrillation?

Objectives: Exploring the long-term consequences of elevated postoperative creatine phosphokinase MB as a surrogate measure of cardiac tissue damage subsequent to coronary artery bypass graft surgery (CABG). Methods: Prospective cohort study including 414 patients subjected to solitary CABG at Odense University Hospital from September 30, 2007, and backwards in time. According to individual postoperative peak creatine phosphokinase MB, patients were assigned to five subgroups. Kaplan Meier survival analysis and Cox proportional-hazard regression evaluated the predictive value of creatine phosphokinase MB on late death from cardiac cause and diagnosis of paroxysmal or persistent atrial fibrillation within 10-years after CABG. Results: There was a general numeric decrease in time to cardiac death with increasing postoperative creatine phosphokinase MB (Log-Rank 0.285). Creatine phosphokinase MB p p p = 0.002) increase in paroxysmal or persistent atrial fibrillation in patients with postoperative atrial fibrillation compared to patients in postoperative sinus rhythm. Conclusions: Postoperative creatine phosphokinase MB was not found predictive of late cardiac death or diagnosis of paroxysmal or persistent atrial fibrillation within 10 years after CABG. However, patients with postoperative atrial fibrillation had increased risk of later developing paroxysmal or persistent atrial fibrillation compared to patients in postoperative sinus rhythm.