Skip to main content
British Heart Journal logoLink to British Heart Journal
. 1981 Apr;45(4):389–392. doi: 10.1136/hrt.45.4.389

Comparison of serum myoglobin and creatine kinase MB isoenzyme in early diagnosis of acute myocardial infarction.

A P Freeman, K R Fatches, I W Carter, M J Cloonan, D E Wilcken
PMCID: PMC482539  PMID: 7225253

Abstract

We compared the clinical usefulness of serum myoglobin and creatine kinase MB (CK MB) isoenzyme determinations in the early diagnosis of acute myocardial infarction in 109 consecutive patients admitted to a coronary care unit. Of these, 37 patients were diagnosed as having definite infarction, three possible infarction, and 69 no infarction, using World Heath Organisation criteria. Blood samples were taken on admission and two to four hours later, Both CK MB and myoglobin were raised in the initial serum samples in 24 of the 37 patients with definite infarction. In an additional seven patients both CK MB and myoglobin were negative in the first specimen though both were detected in the second sample. In five patients CK MB preceded the appearance of myoglobin while in the remaining patient myoglobin appeared before CK MB. We conclude that the detection of serum myoglobin does not offer any clinical advantage over CK MG as an early indicator of myocardial infarction.

Full text

PDF
389

Selected References

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

  1. Blomberg D. J., Kimber W. D., Burke M. D. Creatine kinase isoenzymes. Predictive value in the early diagnosis of acute myocardial infarction. Am J Med. 1975 Oct;59(4):464–469. doi: 10.1016/0002-9343(75)90253-3. [DOI] [PubMed] [Google Scholar]
  2. Cloonan M. J., Bishop G. A., Wilton-Smith P. D., Carter I. W., Allan R. M., Wilcken D. E. An enzyme-immunoassay for myoglobin in human serum and urine. Method development, normal values and application to acute myocardial infarction. Pathology. 1979 Oct;11(4):689–699. doi: 10.3109/00313027909059049. [DOI] [PubMed] [Google Scholar]
  3. Gilkeson G., Stone M. J., Waterman M., Ting R., Gomez-Sanchez C. E., Hull A., Willerson J. T. Detection of myoglobin by radioimmmunoassay in human sera: its usefulness and limitations as an emergency room screening test for acute myocardial infarction. Am Heart J. 1978 Jan;95(1):70–77. doi: 10.1016/0002-8703(78)90398-8. [DOI] [PubMed] [Google Scholar]
  4. Marmor A., Alpan G., Keidar S., Grenadier E., Palant A. The MB isoenzyme of creatine kinase as an indicator of severity of myocardial ischaemia. Lancet. 1978 Oct 14;2(8094):812–814. doi: 10.1016/s0140-6736(78)92590-4. [DOI] [PubMed] [Google Scholar]
  5. Oxley D. K., Bolton M. R., Shaeffer C. W. Myoglobin in myocardial infarction. Results in a coronary-care-unit population. Am J Clin Pathol. 1979 Aug;72(2):137–141. doi: 10.1093/ajcp/72.2.137. [DOI] [PubMed] [Google Scholar]
  6. Rosalki S. B. An improved procedure for serum creatine phosphokinase determination. J Lab Clin Med. 1967 Apr;69(4):696–705. [PubMed] [Google Scholar]
  7. Rosano T. G., Sanders L. A., Johnson E. S., Kenny M. A., Clayson K. J., Strandjord P. E. Myoglobin concentrations and muscle-enzyme activities in serum after myocardial infarction and cardiac arrhythmia. Clin Chem. 1977 May;23(5):868–870. [PubMed] [Google Scholar]
  8. Sonnemaker R. E., Daniels D. L., Craig W. E., Floyd J. L., Bode R. F. Serum myoglobin determination: laboratory and clinical evaluation. J Nucl Med. 1979 Feb;20(2):120–124. [PubMed] [Google Scholar]
  9. Stone M. J., Waterman M. R., Harimoto D., Murray G., Willson N., Platt M. R., Blomqvist G., Willerson J. T. Serum myoglobin level as diagnostic test in patients with acute myocardial infarction. Br Heart J. 1977 Apr;39(4):375–380. doi: 10.1136/hrt.39.4.375. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Stone M. J., Waterman M. R., Poliner L. R., Templeton G. H., Buja L. M., Willerson J. T. Myoglobinemia is an early and quantitative index of acute myocardial infarction. Angiology. 1978 May;29(5):386–392. doi: 10.1177/000331977802900506. [DOI] [PubMed] [Google Scholar]
  11. Tommaso C. L., Salzeider K., Arif M., Klutz W. Serial myoglobin vs. CPK analysis as an indicator of uncomplicated myocardial infarction size and its use in assessing early infarct extension. Am Heart J. 1980 Feb;99(2):149–154. doi: 10.1016/0002-8703(80)90759-0. [DOI] [PubMed] [Google Scholar]
  12. Wagner G. S., Roe C. R., Limbird L. E., Rosati R. A., Wallace A. G. The importance of identification of the myocardial-specific isoenzyme of creatine phosphokinase (MB form) in the diagnosis of acute myocardial infarction. Circulation. 1973 Feb;47(2):263–269. doi: 10.1161/01.cir.47.2.263. [DOI] [PubMed] [Google Scholar]
  13. Willerson J. T., Stone M. J., Ting R., Mukherjee A., Gomez-Sanchez C. E., Lewis P., Hersh L. B. Radioimmunoassay of creatine kinase-B isoenzyme in human sera: results in patients with acute myocardial infarction. Proc Natl Acad Sci U S A. 1977 Apr;74(4):1711–1715. doi: 10.1073/pnas.74.4.1711. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Witherspoon L. R., Shuler S. E., Garcia M. M., Zollinger L. A. Assessment of serum myoglobin as a marker for acute myocardial infarction. J Nucl Med. 1979 Feb;20(2):115–119. [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES