Comparison of five cardiac markers in the detection of reperfusion after thrombolysis in acute myocardial infarction.
OBJECTIVE
To investigate and compare the clinical usefulness of serial measurements of five cardiac marker proteins, namely creatine kinase (CK), CK-MB mass, myoglobin, troponin T, and myosin light chain 1, in the early detection of reperfusion after thrombolytic treatment.


METHODS
Serial blood samples were taken from 26 patients presenting with acute myocardial infarction. Concentrations of the five markers were assayed in each sample. Thrombolytic treatment was given to the patients who were divided into those who reperfused (n = 17, group A) and those who failed to reperfuse (n = 9, group B) on the basis of clinical signs and angiography within 24 h.


RESULTS
The release profiles of CK, CK-MB mass, myoglobin, and troponin T for patients in group A differed from those of patients in group B. No difference was observed in the release profile of myosin light chain 1 between the two groups. The time to peak concentration of CK, CK-MB mass, myoglobin, and troponin T occurred significantly earlier in patients of group A than in those of group B, with myoglobin peaking earlier than the other markers. An index, defined as the ratio of the concentration of each marker immediately before and 2 h after the start of thrombolytic treatment, was calculated for each marker in groups A and B. The 2 h myoglobin and troponin T indices were significantly different between groups A and B. The diagnostic efficiency of the myoglobin index, however, was best at 85%.


CONCLUSIONS
These studies suggest that myoglobin has greater potential than the other markers examined in the detection of reperfusion after thrombolytic treatment.
Lavin
F
F
Cardiology Department, University College Hospital, Galway, Ireland.
Kane
M
M
Forde
A
A
Gannon
F
F
Daly
K
K
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009124:Muscle Proteins / Q000097:blood*; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy*; D009211:Myoglobin / Q000097:blood; D018994:Myosin Light Chains; D009218:Myosins / Q000097:blood; D013300:Streptokinase / Q000627:therapeutic use*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome; D014336:Troponin / Q000097:blood; D020107:Troponin T
D015415:Biomarkers; D007527:Isoenzymes; D009124:Muscle Proteins; D009211:Myoglobin; D018994:Myosin Light Chains; D014336:Troponin; D020107:Troponin T; C076659:myosin light chain I; D003402:Creatine Kinase; D013300:Streptokinase; D010959:Tissue Plasminogen Activator; D009218:Myosins