title: Myocardial reperfusion can be predicted by myoglobin/creatine kinase ratio of a single blood sample obtained at the time of admission.
abstract: To evaluate noninvasive markers for determining the reperfusion status without coronary angiography (CAG) or serial blood sampling in patients with acute myocardial infarction (AMI), two markers were examined: (1) serum myoglobin (Mb) level and (2) serum myoglobin/creatine kinase ratio (Mb/CK). Before emergency CAG a blood sample was drawn from 72 AMI patients within 6 hours after the onset of AMI. CAG revealed thrombolysis in myocardial infarction grades (TIMI) 0 to 1 in 56 and TIMI 2 to 3 in 16 patients (spontaneous reperfusion). No patients had received thrombolytic therapy before admission. TIMI 0 to 1 patients were characterized with lower Mb levels than TIMI 2 to 3 patients at admission (346 +/- 476 vs 1558 +/- 2005, mean +/- SD, p < 0.001). Furthermore, the mean Mb0/CK0 ratio in TIMI 2 to 3 patients, who had already achieved the reperfusion at admission, was significantly higher than that in patients with TIMI 0 to 1 patients (6.5 +/- 3.9 vs 2.1 +/- 1.8, mean +/- SD, p < 0.0001). When Mb0/CK0 > 5.0 was assumed to indicate the sufficient reperfusion at admission, the sensitivity, specificity, and accuracy evaluating the reperfusion status were 75%, 96%, and 92%, respectively. It can be concluded that the reperfusion status can be predicted satisfactorily by a single blood sample obtained at the time of admission without CAG.
authors.affiliation: First Department of Internal Medicine, University of Tokyo, Bunkyo-ku, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Abe
authors.forename: T
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: T
authors.initials: T
authors.lastname: Isshiki
authors.forename: H
authors.initials: H
authors.lastname: Naka
authors.forename: J
authors.initials: J
authors.lastname: Taguchi
authors.forename: N
authors.initials: N
authors.lastname: Ishizaka
authors.forename: K
authors.initials: K
authors.lastname: Kurokawa
authors.forename: F
authors.initials: F
authors.lastname: Saeki
authors.forename: Y
authors.initials: Y
authors.lastname: Ishizaka
authors.forename: K
authors.initials: K
authors.lastname: Ui
mesh_terms: D000368:Aged; D004796:Clinical Enzyme Tests; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D015425:Myocardial Reperfusion; D009211:Myoglobin / Q000097:blood*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D009211:Myoglobin; D003402:Creatine Kinase