BACKGROUND: Coronary artery reperfusion significantly improves outcome in patients with acute myocardial infarction. A noninvasive method for assessing reperfusion in the early stage of infarction should be helpful in patient management. HYPOTHESIS: We sought to assess whether release pattern of myoglobin is helpful in identifying patients with and without reperfusion following thrombolytic therapy for myocardial infarction. METHODS: Myoglobin was measured before thrombolysis, half hourly for 4 h, then every 2 h for 10 h. Myoglobin was analyzed using a ward-based "rapid" and automated analyzer that yielded quantitative results within 10 min of blood collection. RESULTS: In the 15 patients with coronary reperfusion, the time from thrombolysis to peak myoglobin levels (mean +/- SD, 2.4 +/- 1.5 h) was significantly lower than in nonreperfused patients (5.1 +/- 2.9, p < 0.01). As an indicator for reperfusion, a doubling of myoglobin 1 h after streptokinase achieved a sensitivity of 80%, a specificity of 80%, and a predictive accuracy of 80%. CONCLUSIONS: The difference in myoglobin release kinetics is useful in identifying patients without coronary reperfusion and should aid in their management.
BACKGROUND: Coronary artery reperfusion significantly improves outcome in patients with acute myocardial infarction. A noninvasive method for assessing reperfusion in the early stage of infarction should be helpful in patient management. HYPOTHESIS: We sought to assess whether release pattern of myoglobin is helpful in identifying patients with and without reperfusion following thrombolytic therapy for myocardial infarction. METHODS:Myoglobin was measured before thrombolysis, half hourly for 4 h, then every 2 h for 10 h. Myoglobin was analyzed using a ward-based "rapid" and automated analyzer that yielded quantitative results within 10 min of blood collection. RESULTS: In the 15 patients with coronary reperfusion, the time from thrombolysis to peak myoglobin levels (mean +/- SD, 2.4 +/- 1.5 h) was significantly lower than in nonreperfused patients (5.1 +/- 2.9, p < 0.01). As an indicator for reperfusion, a doubling of myoglobin 1 h after streptokinase achieved a sensitivity of 80%, a specificity of 80%, and a predictive accuracy of 80%. CONCLUSIONS: The difference in myoglobin release kinetics is useful in identifying patients without coronary reperfusion and should aid in their management.
Authors: P Clemmensen; E M Ohman; D C Sevilla; N B Wagner; P S Quigley; P Grande; G S Wagner Journal: Am J Cardiol Date: 1992-12-01 Impact factor: 2.778
Authors: R E Rude; W K Poole; J E Muller; Z Turi; J Rutherford; C Parker; R Roberts; D S Raabe; H K Gold; P H Stone Journal: Am J Cardiol Date: 1983-11-01 Impact factor: 2.778