Rashmi Gulia

Abstract

Introduction: Creatine kinase-MB (CK-MB) is considered as sensitive and specific indicator for myocardial infarction. Various methods are available for CK-MB measurement but are associated with inherent shortcomings. The routinely used Immunoinhibition method is evaluated for the various interferents and their impact on the estimated CK-MB value. Materials and Methods: The CK-MB values were analyzed for 500 patient samples whose total CK values were within the normal reference interval. Immunoinhibition method (INH) & N-Acetylcysteine (NAC) methods were used for CK-MB and total CK estimation respectively. Results: The observed mean S.D. for CK was 90.15 48.9 U/L and for CK-MB was 33.29 20.47 U/L. The box and whisker plots were used to represent the data of CK & CK-MB. The CK-MB levels were observed to exceed the total CK under certain circumstances owing to interferents. The CK-MB values were observed to exceed the total CK in 8.6% of the cases. Conclusion: The utility of CK-MB has ever been questioned. It has been categorized as over-used test. The conventional immunoassay methodology for CK-MB measurement is not free from interferences, awareness about these is important while interpreting the results so as to exclude method related artifactual values. Keywords: Creatine kinase, CKMB, Immunoinhibition, Assay interference, Macro- creatine kinase.

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Abstract

Introduction: Heart Disease is number one cause of mortality and a silent epidemic among Indians. The risk of coronary artery disease is found to increase with increase in serum Cholesteryl ester transfer protein (CETP) levels. CETP mediates the exchange of lipids between the lipoproteins. Serum CETP levels of young myocardial infarction (MI) patients are measured to see its correlation with lipid profile. Materials and Methods: This prospective observational case-control study was done on 50 young MI patients and 30 age-matched controls for measuring serum CETP and lipid profile in the biochemistry laboratory of Christian medical college, Ludhiana. The study started from 1st November 2014 till full enrolment. Serum CETP were quantified by Enzyme Linked Immunosorbent Assay (ELISA) method. Results: The mean serum CETP value observed among cases was 1168.7738.3 mg/L and that among cases was 978.4337.2 mg/L with a p-value was 0.18. The correlation coefficients of serum CETP with total cholesterol, triglyceride, Low density lipoprotein and high density lipoprotein are -0.083, -0.037, -0.020 and 0.050 and similarly among controls were -0.292, 0.086, 0.282, 0.337 respectively. Conclusion: The serum CETP concentrations were found to be higher in cases as compared to the controls but were not found to be statistically significant, while no correlation was found between serum CETP. Keywords: Myocardial infarction, Serum CETP levels, Lipid profile, Lipoproteins, ELISA assay concentration and lipid profile in young MI cases.  

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