EARLY RELEASE OF GLYCOGEN-PHOSPHORYLASE IN PATIENTS WITH UNSTABLE ANGINA AND TRANSIENT ST-T ALTERATIONS

Objective-To determine whether transient ST-T alterations in patients with unstable angina are associated with an increase in plasma glycoge n phosphorylase BB concentrations on admission to hospital. Design-Pro spective screening of patients with unstable angina for markers of myo cardial cell damage. Setting-Accident and emergency department of univ ersity hospital. Patients-48 consecutive patients admitted for angina pectoris (18 with transient ST-T alterations). None of the patients ha d acute myocardial infarction according to standard criteria. Main out come measures-Creatine kinase and creatine kinase MB activities, creat ine kinase Puff mass concentration, and myoglobin, cardiac troponin T, and glycogen phosphorylase BB concentrations on admission. Results-Al l variables except for creatine kinase and creatine kinase MB activiti es were significantly higher on admission in patients with unstable an gina and transient ST-T alterations than in patients without. However, glycogen phosphorylase BB concentration was the only marker that was significantly (p = 0.0001) increased above its discriminator value in most patients (16). In the 18 patients with transient ST-T alterations creatine kinase MB mass concentration and troponin T and myoglobin co ncentrations were significantly (p = 0.0001) less commonly increased o n admission (in five, three, and two patients, respectively). Conclusi ons-The early release of glycogen phosphorylase BB may help to identif y high risk patients with unstable angina even on admission to an emer gency department. Glycogen phosphorylase BB concentrations could help to guide decisions about patient management.