Peak XXXX kinase as a measure of effectiveness of thrombolytic therapy in @entity583 .

@entity1 @entity583 @entity1188 @entity908
As part of the National Heart, Lung, and Blood Institute multicenter Thrombolysis in @entity583 Trial, the time to peak plasma @entity908 kinase (CK) activity as a marker of reperfusion in 272 @entity1 with validated @entity583 was analyzed. @entity1 were treated with either tissue-type plasminogen activator or streptokinase by intravenous administration. All @entity1 underwent acute coronary angiography. The @entity1188 was identified and thrombolytic therapy administered. Reperfusion at 90 minutes was documented by angiography. CK was determined before institution of therapy and every 4 hours thereafter for the first 24 hours. @entity1 were classified into 3 groups for comparative purposes: group 1--occlusion with no reperfusion (n = 119); group 2--occlusion with reperfusion (n = 98); and group 3--subtotal occlusion (n = 55). Early (within 4 hours after treatment) and late (more than 16 hours after treatment) peaking of CK differentiated @entity1 with drug-induced perfusion from those without reperfusion. Although peak CK between 5 and 11 hours after drug treatment did suggest perfusion through the @entity1188 , it did not differentiate between drug-induced and spontaneous reperfusion. Clinically, early peak CK is a useful noninvasive means of assessing coronary artery patency. However, in clinical trials assessing drug therapy, the use of peak CK may overestimate drug effectiveness by including @entity1 with spontaneous reperfusion.
