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. 1983 Dec;50(6):520–524. doi: 10.1136/hrt.50.6.520

Correlation between enzymatic estimation of infarct size and early mortality rate.

J Herlitz, A Hjalmarson, J Waldenström, K Swedberg, F Waagstein, A Waldenström
PMCID: PMC481453  PMID: 6651994

Abstract

In 585 patients with a first acute myocardial infarction the maximum activity of heat stable lactate dehydrogenase (EC 1.1.1.27) was correlated with mortality at three months. The patients participated in a double blind trial with metoprolol in acute myocardial infarction. In all patients not taking a beta blocker a highly significant correlation was found, but this was not evident in those who were. When patients with anterior or inferior infarctions treated with a placebo were analysed separately the correlation remained, as it did when the patients who were alive on the fourth day after the onset of pain were analysed separately. No correlation was observed between enzyme activity and three month mortality in these subgroups if only patients treated with metoprolol were included. In a subsample of only 171 patients it was found that the maximum activity of creatine kinase (EC 2.7.3.2) and creatine kinase subunit B did not correlate with three month mortality regardless of treatment. Thus it is concluded that when a sufficiently large number of patients are investigated there is a highly significant correlation between the enzymatic estimation of infarct size and early mortality in acute myocardial infarction. This relation did not persist when patients treated with beta blockade were analysed.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bleifeld W., Mathey D., Hanrath P., Buss H., Effert S. Infarct size estimated from serial serum creatine phosphokinase in relation to left ventricular hemodynamics. Circulation. 1977 Feb;55(2):303–311. doi: 10.1161/01.cir.55.2.303. [DOI] [PubMed] [Google Scholar]
  2. Brydon W. G., Smith A. F. An appraisal of routine methods for the determination of the anodal isoenzymes of lactate dehydrogenase. Clin Chim Acta. 1973 Feb 12;43(3):361–369. doi: 10.1016/0009-8981(73)90475-0. [DOI] [PubMed] [Google Scholar]
  3. Erhardt L. R. Clinical and pathological observations in different types of acute myocardial infarction. Acta Med Scand Suppl. 1974;560:1–78. [PubMed] [Google Scholar]
  4. Gerhardt W., Waldenström J. Creatine kinase B-subunit activity in serum after immunoinhibition of M-subunit activity. Clin Chem. 1979 Jul;25(7):1274–1280. [PubMed] [Google Scholar]
  5. Grande P., Hansen B. F., Christiansen C., Naestoft J. Acute myocardial infarct size estimated by serum CK-MB determinations: clinical accuracy and prognostic relevance utilizing a practical modification of the isoenzyme approach. Am Heart J. 1981 May;101(5):582–586. doi: 10.1016/0002-8703(81)90224-6. [DOI] [PubMed] [Google Scholar]
  6. Hillis L. D., Askenazi J., Braunwald E., Radvany P., Muller J. E., Fishbein M. C., Maroko P. R. Use of changes in the epicardial QRS complex to assess interventions which modify the extent of myocardial necrosis following coronary artery occlusion. Circulation. 1976 Oct;54(4):591–598. doi: 10.1161/01.cir.54.4.591. [DOI] [PubMed] [Google Scholar]
  7. Hjalmarson A., Elmfeldt D., Herlitz J., Holmberg S., Málek I., Nyberg G., Rydén L., Swedberg K., Vedin A., Waagstein F. Effect on mortality of metoprolol in acute myocardial infarction. A double-blind randomised trial. Lancet. 1981 Oct 17;2(8251):823–827. doi: 10.1016/s0140-6736(81)91101-6. [DOI] [PubMed] [Google Scholar]
  8. Kibe O., Nilsson N. J. Observations on the diagnostic and prognostic value of some enzyme tests in myocardial infarction. Acta Med Scand. 1967 Nov;182(5):597–610. doi: 10.1111/j.0954-6820.1967.tb10886.x. [DOI] [PubMed] [Google Scholar]
  9. Konttinen A., Somer H. Determination of serum creatine kinase isoenzymes in myocardial infarction. Am J Cardiol. 1972 Jun;29(6):817–820. doi: 10.1016/0002-9149(72)90501-2. [DOI] [PubMed] [Google Scholar]
  10. Maroko P. R., Deboer L. W., Davis R. F. Infarct size reduction: A critical review. Adv Cardiol. 1980;27:127–169. doi: 10.1159/000383982. [DOI] [PubMed] [Google Scholar]
  11. Maroko P. R., Hillis L. D., Muller J. E., Tavazzi L., Heyndrickx G. R., Ray M., Chiariello M., Distante A., Askenazi J., Salerno J. Favorable effects of hyaluronidase on electrocardiographic evidence of necrosis in patients with acute myocardial infarction. N Engl J Med. 1977 Apr 21;296(16):898–903. doi: 10.1056/NEJM197704212961603. [DOI] [PubMed] [Google Scholar]
  12. Nordlander R., Nyquist O., Sylvén C. Estimation of infarct size by creatine kinase. A comparison between maximal value, planimetry and computer calculation. Cardiology. 1981;68(4):201–205. doi: 10.1159/000173283. [DOI] [PubMed] [Google Scholar]
  13. Roe C. R. Validity of estimating myocardial infarct size from serial measurements of enzyme activity in the serum. Clin Chem. 1977 Oct;23(10):1807–1812. [PubMed] [Google Scholar]
  14. Shell W. E., Kjekshus J. K., Sobel B. E. Quantitative assessment of the extent of myocardial infarction in the conscious dog by means of analysis of serial changes in serum creatine phosphokinase activity. J Clin Invest. 1971 Dec;50(12):2614–2625. doi: 10.1172/JCI106762. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Sobel B. E., Shell W. E. Serum enzyme determinations in the diagnosis and assessment of myocardial infarction. Circulation. 1972 Feb;45(2):471–482. doi: 10.1161/01.cir.45.2.471. [DOI] [PubMed] [Google Scholar]
  16. Thanavaro S., Krone R. J., Kleiger R. E., Province M. A., Miller J. P., deMello V. R., Oliver G. C. In-hospital prognosis of patients with first nontransmural and transmural infarctions. Circulation. 1980 Jan;61(1):29–33. doi: 10.1161/01.cir.61.1.29. [DOI] [PubMed] [Google Scholar]

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