(J Zagreb, Croatia SUMMARY. The concentrations of four acute phase proteins were measured in sera of 40 patients with acute myocardial infarction (AMI) to evaluate their behaviour from day-to-day and to find out if they can serve for early prediction of postinfarction complications and mortality rate. Peak levels of serum amyloid A protein (SAA) were increased up to 5000-fold above the normal value and those of C-reactive protein (CRP) about loo-fold, 3 days after AMI. 0/ l-antichymotrypsin (ACT) and 0/ l-acid glycoprotein (AGP) peak levels were increased up to eightfold above their normal values. Patients who developed postinfarction complications had significantly higher SAA values on admission than those without complications (mean values of 379 and 45mg/L, respectively; P

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Summary: Fifty adults hospitalized with extensive burns formed the basis of the present study. Serum amyloid A protein, C-reactive protein, a r antichymotrypsm and a r acid glycoprotein were measured in serum samples taken on admission, and 3 and 7 days later. Fatal outcome was observed in 13 out of 14 (93%) patients with serum amyloid A protein over 100 mg/1 on admission and in only 2 of the remaining 36 (6%) patients with serum amyloid A protein below 100 mg/1. The median serum amyloid A protein concentration on admission in 15 patients with fatal outcome was 134 mg/1, and only 30 mg/1 in 35 patients who recovered (p < 0.00005). As a reference value, the level of 100mg serum amyloid A protein per litre on admission gave an evident predictive value (93%) and sensitivity (87%) for fatal outcome. The difference between serum amyloid A protein concentrations in patients with complications (median 642 mg/1) and those without complications (median 250 mg/1) was statistically very significant (p = 0.0003) three days after burn injury. The level of 400 mg/1 as a reference value 3 days after burn injury gave a reasonable predictive value (80%) and sensitivity (74%) for the development of postburn complications, but patients who died did not develop a hypermetabolic reaction and their serum amyloid A protein concentration remained below 400 mg/1, despite high serum amyloid A protein concentrations observed on admission (above 100 mg/1). No statistical significance was observed for the other 3 acute phase proteins investigated in this study.

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