Rapid myoglobin analysis to assess coronary artery reperfusion after acute myocardial infarction.
BACKGROUND
Coronary artery reperfusion significantly improves outcome in patients with acute myocardial infarction. A noninvasive method for assessing reperfusion in the early stage of infarction should be helpful in patient management.


OBJECTIVE
We sought to assess whether release pattern of myoglobin is helpful in identifying patients with and without reperfusion following thrombolytic therapy for myocardial infarction.


METHODS
Myoglobin was measured before thrombolysis, half hourly for 4 h, then every 2 h for 10 h. Myoglobin was analyzed using a ward-based "rapid" and automated analyzer that yielded quantitative results within 10 min of blood collection.


RESULTS
In the 15 patients with coronary reperfusion, the time from thrombolysis to peak myoglobin levels (mean +/- SD, 2.4 +/- 1.5 h) was significantly lower than in nonreperfused patients (5.1 +/- 2.9, p < 0.01). As an indicator for reperfusion, a doubling of myoglobin 1 h after streptokinase achieved a sensitivity of 80%, a specificity of 80%, and a predictive accuracy of 80%.


CONCLUSIONS
The difference in myoglobin release kinetics is useful in identifying patients without coronary reperfusion and should aid in their management.
Lee
H S
HS
Department of Cardiology, Aberdeen Royal Infirmary, Scotland.
Cross
S J
SJ
Jennings
K
K
D015415:Biomarkers / Q000097:blood; D003331:Coronary Vessels; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology; D015425:Myocardial Reperfusion / Q000379:methods*; D009211:Myoglobin / Q000097:blood*; D011237:Predictive Value of Tests; D013300:Streptokinase / Q000627:therapeutic use; D015912:Thrombolytic Therapy / Q000379:methods; D016896:Treatment Outcome
D015415:Biomarkers; D005343:Fibrinolytic Agents; D009211:Myoglobin; D013300:Streptokinase