Abstract |
We have examined the use of serum myoglobin concentration in the management of cases of suspected acute myocardial infarction (AMI). In a series of 51 patients myoglobin, used as a discriminant, correctly identified 97% (28/29) of cases as AMI with one false positive. Initial clinical judgement based on history, examination and the electrocardiogram correctly identified 66% (19/29) of cases with one false positive. These patients were given streptokinase. However, in these further identified AMI patients, 78% (7/9) had small enzyme rises with non-Q wave infarction and/or non-ST elevation and therefore may not have benefited from thrombolytic therapy in contrast to the Q wave/raised ST segment infarcts with large enzyme rises identified by clinical means. Enthusiasm for myoglobin estimation, where used as a discriminant for AMI, as a direct pointer to thrombolysis in the early diagnosis of AMI should be tempered by this finding.
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Authors | H J Southgate, A J Fry, T Pickett, A Jones, M Signy |
Journal | Clinica chimica acta; international journal of clinical chemistry
(Clin Chim Acta)
Vol. 259
Issue 1-2
Pg. 41-9
(Mar 18 1997)
ISSN: 0009-8981 [Print] Netherlands |
PMID | 9086293
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Aged
- False Positive Reactions
- Female
- Humans
- Male
- Middle Aged
- Myocardial Infarction
(blood, diagnosis, drug therapy)
- Myoglobin
(analysis)
- Sensitivity and Specificity
- Streptokinase
(therapeutic use)
- Thrombolytic Therapy
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