Creatine kinase kinetics and myocardial infarction in different regions of the left ventricle.

The interval from the onset of infarction pain to culmination of plasma creatine kinase activity (t-peak) was measured in 68 patients with their first myocardial infarction. There is a major difference in this parameter in patients with infarction in the area of the right coronary artery and that supplied by the left anterior descending coronary artery (LAD). While, in 29 patients with infarction in the right coronary artery area, t-peak was 17.7 +/- 4.7 hours, in 39 subjects with infarction in area supplied by the LAD, t-peak was 13.2 +/- 4.6 hours (p less than 0.001). The type of thrombolytic treatment (intravenous or intracoronary, used no difference, just as the time from onset of pain to start of therapy, infarct size and presence or absence of collaterals. A detailed analysis of creatine kinase culmination in relation to the type of artery recanalization is given. The authors conclude that, besides the known factors, creatine kinase culmination is influenced also by the necrosis site, a fact somewhat modifying the informative value of this parameter. However, explanations of this phenomenon are only hypothetical at the present time.