The prognostic value of serum acetylcholinesterase in myocardial infarction. Theoretical and clinical considerations.
The aim of the present work was to determine experimentally the prognostic value of reduced activity of serum acetylcholinesterase (ACE) in cases of acute myocardial infarction (AMI). In the first part of the research we studied the mechanism of this reduction by comparing the serum results with the levels of the enzyme in cardiac tissue in such cases. It was found that ACE activity is reduced in serum and also in cardiac tissue in AMI, in contrast to creatine kinase (CK) that is augmented in serum but reduced in cardiac tissue. This fact was interpreted as a "reduced cardiac flow of ACE," in contrast to the "augmented cardiac clearance of CK" in similar cases. In the second part of our research, 50 patients, admitted in our hospital for AMI, were examined and their blood analysed mainly for ACE and CK at brief intervals (every 2-3 days), during hospitalization, and thereafter every 1-2 weeks for 1-4 months. From the results of ACE activity it was possible to classify these variations into four groups, each of them having a defined prognostic value for the evolution of the AMI, a persistent reduced serum activity being interpreted as a bad, severe prognosis, with high morbidity or mortality (groups II and III). We suggest, therefore, that the determination of ACE in serum in cases of AMI, especially before discharge home of such patients, may be an additional useful laboratory test in such cases.
D000110:Acetylcholinesterase / Q000097:blood* / Q000378:metabolism; D000328:Adult; D000368:Aged; D001219:Aspartate Aminotransferases / Q000097:blood; D004796:Clinical Enzyme Tests; D003402:Creatine Kinase / Q000097:blood / Q000378:metabolism; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D009206:Myocardium / Q000201:enzymology; D011379:Prognosis
D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D003402:Creatine Kinase; D000110:Acetylcholinesterase