INABILITY OF SERUM MYOCYTE DEATH MARKERS TO PREDICT ACUTE CARDIAC ALLOGRAFT-REJECTION

Acute cardiac rejection involves myocyte necrosis. Hence, markers of m yocyte death may be useful in diagnosing rejection. Creatine kinase MB , MB isoforms, and troponins I and T were measured in 186 patients und ergoing 365 endomyocardial biopsies. No differences were noted with re jection (rejectors vs. nonrejectors: CK=63.8 U/L and 86.6 U/L, P=0.013 81; CK MB=2.04 ng/ml and 2.06 ng/ml, P=0.949; troponin T=0.134 ng/ml a nd 0.0881 ng/ml, P=0.374; troponin I=0.216 ng/ml and 0.707 ng/ml, P=0. 367). The time course elf troponins T and I levels in rejectors and no nrejectors do not differ with both groups having early elevations. Mar kers of myocyte death are inadequate predictors of acute rejection in cardiac allografts. The time course of troponins T and I suggests a po ssible role as prognostic indicators of outcome.