COMPARISON OF 5 CARDIAC MARKERS IN THE DETECTION OF REPERFUSION AFTERTHROMBOLYSIS IN ACUTE MYOCARDIAL-INFARCTION

Objective-To investigate and compare the clinical usefulness of serial measurements of five cardiac marker proteins, namely creatine kinase (CK), CK-MB mass, myoglobin, troponin T, and myosin light chain 1, in the early detection of reperfusion after thrombolytic treatment. Metho d-Serial blood samples were taken from 26 patients presenting with acu te myocardial infarction. Concentrations of the five markers were assa yed in each sample. Thrombolytic treatment was given to the patients w ho were divided into those who reperfused (n = 17, group A) and those who failed to reperfuse (n = 9, group B) on the basis of clinical sign s and angiography within 24 h. Results-The release profiles of CK, CK- ME mass, myoglobin, and troponin T for patients in group A differed fr om those of patients in group B. No difference was observed in the rel ease profile of myosin light chain 1 between the two groups. The time to peak concentration of CK, CKMB mass, myoglobin, and troponin T occu rred significantly earlier in patients of group A than in those of gro up B, with myoglobin peaking earlier than the other markers. An index, defined as the ratio of the concentration of each marker immediately before and 2 h after the start of thrombolytic treatment, was calculat ed for each marker in groups A and B. The 2 h myoglobin and troponin T indices were significantly different between Cardiology groups A and B. The diagnostic efficiency Department, of the myoglobin index, howev er, was best at 85%. Conclusions-These studies suggest that myoglobin has greater potential than the other markers examined in the detection of reperfusion after thrombolytic treatment.