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July 1987

The Prevalence and Prognosis of Minimally Elevated Creatine Kinase—Myocardial Band Activity in Elderly Patients With Syncope

Author Affiliations

From the Hebrew Rehabilitation Center for Aged (Dr Lipsitz and Ms Pluchino); Joint Department of Medicine of Beth Israel and Brigham and Women's Hospitals (Drs Lipsitz and Wei); The Charles A. Dana Research Institute and Harvard-Thorndike Laboratory of Beth Israel Hospital (Drs Lipsitz and Wei); the Division on Aging, Harvard Medical School (Drs Lipsitz and Wei); and the Geriatric Research Education Clinical Center, West Roxbury/Brockton Veterans Administration Medical Center (Dr Wei), Boston.

Arch Intern Med. 1987;147(7):1321-1323. doi:10.1001/archinte.1987.00370070135020

• Syncope in elderly patients is often the initial manifestation of myocardial infarction (MI). Small elevations in creatine kinase—myocardial band (CK-MB) activity following syncope may represent MI, transient myocardial hypoperfusion, or insignificant background activity. To determine the prevalence and prognostic significance of minimal CK-MB elevations in elderly patients with syncope, serial serum CK-MB activities and subsequent survival experiences were determined for elderly syncope patients with and without MI, and for agematched nonsyncopal controls. While all syncope patients with MI by specific clinical criteria had one or more abnormal CK-MB levels (>5 U/L) and died within 31 months, 10% of syncope patients without MI and 10% of controls had abnormal CK-MB with no impact on mortality. Using standard clinical laboratory techniques, minimal elevation in CK-MB was found in 10% of elderly subjects with and without syncope and probably had no prognostic significance.

(Arch Intern Med 1987;147:1321-1323)