We analyzed CK and CK-MB levels over 24 h in 15 male subjects admitted for alcohol detoxification following recent heavy ingestion. None had clinical or electrocardiographic evidence of myocardial ischemia or infarction. The mean 0-hour serum alcohol level ± SD was 342 ± 101 mg/dl. CK levels were measured by Kodak Ektachem and Abbott IMx assays, and CK-MB levels were determined by these assays and the Hybritech isoenzyme test. In 36% of the patients elevated 0-hour CK levels by the IMx and Ektachem assays were observed. The CK levels measured every 8 h decreased so that by 24 h CK was elevated in 1 patient by the Ektachem assay and in 2 by the IMx assay. Only 1 patient (7%) had an elevated 0-hour CK-MB value by two of the three assays, and it is unclear whether the source was cardiac or extracardiac. We conclude that: (1) elevated CK levels are common in heavy alcohol use patients without evidence of myocardial ischemia; (2) CK values over the first 24 h are decremental, not rising and falling as is typical of myocardial infarction and (3) current isoenzyme immunoassays eliminate a cardiac cause for elevated CK in most of these patients. These findings may assist in the evaluation of alcoholic patients with chest pain.

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