Cumulative enzyme release as a measure of infarct size in patients with acute myocardial infarction receiving thrombolytic therapy.
Infarct size can be assessed in patients with myocardial infarction by calculating cumulative enzyme release. The two compartment model is used in patients who received thrombolytic therapy as well as in patients who were not treated with thrombolytic agents. The most practical approach is to calculate cumulative release of lactate dehydrogenase (LDH). Blood samples have to be obtained twice daily during the first two days, and once daily during day three to five. Cumulative LDH release can then be calculated with help of a simple computer program, presently available for use on a PC. Cumulative enzyme release was calculated from the patients who were included in the study with intracoronary streptokinase conducted by the Intervuniversity Cardiology Institute of the Netherlands, in the trial conducted by Anderson, in the ISAM study, and in the trial with rt-PA versus placebo that was coordinated by the European rt-PA study group. In all studies it was demonstrated that thrombolytic therapy led to a limitation of infarct size (less cumulative enzyme release) when compared to controls. In future trials calculation of cumulative enzyme release will have to be incorporated in the design of those trials in which the effectiveness of proposed new therapeutic regimens (like acute PTCA) is tested in patients with acute myocardial infarction and will be compared to the nowadays "standard" therapy with thrombolytic agents.
Vermeer
F
F
Department of Cardiology, University Hospital Maastricht, The Netherlands.
Van der Laarse
A
A
D000208:Acute Disease; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood* / Q000378:metabolism; D008432:Mathematical Computing; D009203:Myocardial Infarction / Q000201:enzymology* / Q000473:pathology / Q000628:therapy; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
D007770:L-Lactate Dehydrogenase