[Serum myoglobin as a non-invasive marker of coronary reperfusion after intravenous thrombolytic therapy in patients with acute myocardial infarction].
Non-invasive methods for evaluation of intravenous thrombolytic treatment in patients with acute myocardial infarction (AMI) are needed, since approximately 30% of the patients never obtain coronary reperfusion. These patients could be candidates for additional thrombolytic treatment or acute PTCA. This study included 63 AMI patients. Intravenous and/or intracoronary thrombolysis was given to 52 patients, and 11 patients received conservative treatment (placebo). Serum myoglobin was measured every 15 min. Acute coronary angiography showed a patent coronary artery in 49 patients ("Reperfusion" group), and 14 patients had no coronary reperfusion ("No-Reperfusion" group). Mean time to peak serum myoglobin was 149 (57-194) minutes in the "Reperfusion" group and 476 (330-660) minutes in the "No-Reperfusion" group, p < 0.0001. An observed peak serum myoglobin < 5 hrs. after initiation of intravenous thrombolysis would indicate coronary reperfusion with sensitivity = 0.94; specificity = 0.79; predictive values of positive and negative test: 0.94 and 0.79, respectively. It is concluded that an peak serum myoglobin < five hrs. after start of thrombolysis predicts reperfusion status with a high level of accuracy.
Medicinsk afdeling B, Rigshospitalet, København.
B
B
Jurlander
P M
PM
Clemmensen
E M
EM
Ohman
G S
GS
Wagner
P
P
Grande
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology; D015425:Myocardial Reperfusion; D009211:Myoglobin / Q000097:blood*; D011379:Prognosis; D015912:Thrombolytic Therapy
D015415:Biomarkers; D009211:Myoglobin
Serummyoglobin som ikkeinvasiv markør for koronar reperfusion efter intravenøs trombolysebehandling hos patienter med akut myokardieinfarkt.