Serum myoglobin/carbonic anhydrase III ratio as a marker of reperfusion after myocardial infarction.

Abstract

BACKGROUND:

Coronary patency is important for short- and long-term outcome after myocardial infarction. Serum myoglobin concentration is a sensitive marker of myocardial damage and its specificity can be improved by simultaneous measurement of carbonic anhydrase III, a skeletal muscle marker. In the present study we evaluated the role of myoglobin/carbonic anhydrase III ratio as a non-invasive marker of reperfusion.

METHODS:

We measured myoglobin, carbonic anhydrase III and creatine kinase MB-fraction release serially in 29 patients with acute myocardial infarction treated with thrombolysis and in 28 patients treated with primary coronary angioplasty.

RESULTS:

Thrombolytic therapy was followed by a 9.1+/-2.2-fold increase in myoglobin and 10.8+/-3.3-fold increase in creatine kinase MB-fraction during the first hour of treatment, while carbonic anhydrase III remained unchanged. The peak value of myoglobin/carbonic anhydrase III ratio was found at 2 h and that of creatine kinase MB-fraction at 8 h after thrombolysis. Knowledge of the reperfusion time point during primary angioplasty and follow-up of cardiac markers revealed that cut-off points of 3 and 10 h for the peak values of myoglobin/carbonic anhydrase III ratio and creatine kinase MB-fraction can be used as indicators for reperfusion, respectively. Myoglobin/carbonic anhydrase III ratio measured before treatment and at 2 and 4 h after the onset of treatment screened 23 of those 25 patients with probable reperfusion after thrombolysis.

CONCLUSIONS:

We conclude that measuring myoglobin/carbonic anhydrase III ratio during the first hours after initiation of thrombolysis may be useful in evaluating the success of reperfusion after acute myocardial infarction.

• Authors: Pekka Vuotikka, Paavo Uusimaa, Matti Niemelä, Kalervo Väänänen, Juhani Vuori, Keijo Peuhkurinen
• Journal: International journal of cardiology (Int J Cardiol) Vol. 91 Issue 2-3 Pg. 137-44 (Oct 2003) ISSN: 0167-5273 [Print] Netherlands
• PMID: 14559123 (Publication Type: Comparative Study, Evaluation Study, Journal Article)

Chemical References

• Biomarkers
• Fibrinolytic Agents
• Isoenzymes
• Myoglobin
• Creatine Kinase
• Creatine Kinase, MB Form
• Streptokinase
• Tissue Plasminogen Activator
• Carbonic Anhydrase III

Topics

• Angioplasty, Balloon, Coronary
• Biomarkers (blood)
• Carbonic Anhydrase III (blood, drug effects)
• Coronary Artery Disease (blood, therapy)
• Creatine Kinase (blood, drug effects)
• Creatine Kinase, MB Form
• Emergency Service, Hospital
• Female
• Fibrinolytic Agents (therapeutic use)
• Finland
• Follow-Up Studies
• Humans
• Isoenzymes (blood, drug effects)
• Length of Stay
• Male
• Middle Aged
• Myocardial Infarction (blood, therapy)
• Myocardial Reperfusion
• Myoglobin (blood, drug effects)
• Patient Admission
• Postoperative Complications (etiology, mortality, surgery)
• Predictive Value of Tests
• Reoperation
• Streptokinase (therapeutic use)
• Thrombolytic Therapy
• Time Factors
• Tissue Plasminogen Activator (therapeutic use)
• Treatment Outcome