EARLY DETECTION OF SUCCESSFUL CORONARY REPERFUSION BASED ON SERUM MYOGLOBIN CONCENTRATION - COMPARISON WITH SERUM CREATINE-KINASE ISOENZYMEMB ACTIVITY

The usefulness of serum myoglobin (Mb) concentration for early detecti on of successful reperfusion was compared with that of creatine kinase isoenzyme MB (CKMB) activity in 49 patients with acute myocardial inf arction. To determine accurately the time of reperfusion, we performed coronary angiography every 5 minutes during reperfusion therapy. Repe rfusion was obtained in 32 patients (reperfused group) but not in 17 p atients (nonreperfused group) until 60 minutes after the initiation of reperfusion therapy. Blood samples were taken before and 15, 30, and 60 minutes after the angiographic confirmation of reperfusion in the r eperfused group. In the nonreperfused group, samples were taken before and 15, 30, and 60 minutes after the initiation of treatment. We calc ulated the Mb ratio (value after reperfusion or treatment initiation t o value before) and CKMB ratio (value after to value before). When val ues >2.4 for the Mb ratio or >2.0 for the CKMB ratio were used as the criteria for reperfusion within 60 minutes after initiation of treatme nt, the sensitivities were 91% and 56% at 15 minutes after reperfusion , 97% and 84% at 30 minutes, and 100% and 100% at 60 minutes, respecti vely. For each ratio the specificity of detection was 100% at all time s evaluated. Thus the Mb ratio accurately detected the success of repe rfusion as early as 15 minutes after reperfusion and may be more usefu l than the CKMB ratio for detecting the success of reperfusion within 30 minutes.