Open AccessRapid myoglobin analysis to assess coronary artery reperfusion after acute myocardial infarction
Author(s) -
Lee Hai Shiang,
Cross Stephen J.,
Jennings Kevin
Publication year - 1997
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960200909
Subject(s) - myoglobin , medicine , thrombolysis , myocardial infarction , streptokinase , cardiology , reperfusion therapy , artery , chemistry , organic chemistry
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. Hypothesis :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.