title: [Enzyme status in myocardial infarction].
abstract: Less than 50% of the patients sent to hospital with suspected acute myocardial infarction do in fact suffer from myocardial necrosis. Changes in serum-enzyme levels are important findings when diagnosing acute myocardial infarction. Blood sampling frequency and which enzymes to measure are crucial for obtaining maximum information. We have studied different enzyme-regimes for the purpose of diagnosing acute myocardial infarction quickly and reliably. It is also necessary to consider consumption of resources. In our study, myoglobin was the best early parameter. The efficiency was only 66%, however, and the specificity was low. We therefore conclude that reliable early diagnosis of acute myocardial infarction based on serum-analyses is not yet possible. The best results were achieved using a strategy consisting of five blood samples (every eight hours during the first 24 hours and a final sample about 48 hours after hospitalisation). Changes in the activities of CK and LD in this period gave valuable information for the diagnosis, the size (measured as an increase in enzyme activity) of an eventual acute myocardial infarction, and the dynamic development of the disease. The sensitivity of the Nordic recommended regime, i.e. two samplings 10-20 hours after start of symptoms, was low (75%). The problem was estimating when the necrotic process had started.
authors.forename: L F
authors.initials: LF
authors.lastname: Engebretsen
authors.forename: J H
authors.initials: JH
authors.lastname: Strømme
authors.forename: O
authors.initials: O
authors.lastname: Skjaeggestad
authors.forename: H P
authors.initials: HP
authors.lastname: Dørum
mesh_terms: D001219:Aspartate Aminotransferases / Q000097:blood; D001800:Blood Specimen Collection / Q000379:methods; D003402:Creatine Kinase / Q000097:blood; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D009203:Myocardial Infarction / Q000097:blood / Q000201:enzymology*; D009211:Myoglobin / Q000097:blood
chemical_list: D009211:Myoglobin; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D003402:Creatine Kinase
vernacular_title: Enzymstatus ved hjerteinfarkt.