Myoglobin—A marker of reperfusion and a prognostic indicator in patients with acute myocardial infarction

Abstract

SummaryBackground: Early noninvasive identification of patients with occluded infarct-related arteries after thrombolysis has important prognostic and therapeutic implications. Recent reports indicate that plasma kinetics of cardiac marker proteins could be very useful in diagnosis of myocardial reperfusion. Although angiographic assessment remains the ideal procedure for determining patency, it is expensive, invasive, not within the reach of most patients in developing countries, and the long-term follow-up data are still sparse.Hypothesis: The present study was undertaken to investigate whether plasma kinetics of myoglobin in conjunction with clinical markers and another biochemical marker, creatine kinase, could be used to predict myocardial reperfusion more accurately and to investigate the correlation between myoglobin release after thrombolysis and mortality in patients with acute myocardial infarction (AMI) over a follow-up period of 18 months.Methods: Eighty-three consecutive patients with AMI receiving streptokinase treatment were studied for plasma kinetics of myoglobin in conjunction with clinical markers and creatine kinase to predict reperfusion and were followed for a period of 18 months.Results: Increased baseline mean ± standard deviation levels of myoglobin were observed among "nonresponders" to

Monitoring Acute Myocardial Infarction Complicated with Cardiogenic Shock — from the Emergency Room to Coronary Care Units

“…19 The kinetics of plasmatic myoglobin levels have been shown to be a reliable way for assessing the coronary artery patency following thrombolytic therapy in MI patients; increased baseline levels of this enzyme were observed in patients who did not respond to streptokinase, while there was a significantly higher myoglobin release among responders to thrombolysis as compared to non-responders. 33 The Heart-Type Fatty Acid Binding Protein (H-FABP) is one of the most abundant proteins in the cardiac muscle, absent from the plasma or interstitial fluid, that is released during an episode of myocardial necrosis. 34 H-FABP is released into the blood stream within 2 hours from symptom onset, with a peak at 4 to 6 hours, having an over 80% sensitivity in diagnosing AMI.…”

Prognostic value of serum myoglobin in patients after cardiac surgery

“…In general, myoglobin serum level has been found to increase slightly after extended muscular activity, or even more after muscular injury [2][3][4][5] or during acute myocardial infarction (AMI) [6]. Furthermore, myoglobin as a marker of myocardial damage and injury has been shown to be of prognostic value in patients with cardiovascular events, i.e., acute coronary syndrome [7], acute pulmonary embolism [8], and after thrombolytic treatment for coronary syndromes [9].…”

“…Consequently, serum myoglobin has found its place in clinical routine as a determinant in diagnosing AMI [14] or acute coronary syndromes [15]. Furthermore, serum myoglobin has been suggested as a postoperative marker of graft failure in cardiac bypass operations [16] and after thrombolytic treatment [9,14]. There are numerous studies on the value of serum myoglobin in the cardiology literature; in particular, studies which have compared serum myoglobin and CK-MB levels in the diagnosis of AMI [14,17].…”

SERS-Active Substrates Nanoengineering Based on e-Beam Evaporated Self-Assembled Silver Films

“…Detection of ultra-low proteins concentration in solution using novel physical effects like plasmonics, surface-enhanced Raman spectroscopy, and photonic waveguide-based sensors are promising techniques for novel medical diagnostics [1][2][3][4][5][6][7]. In particular, a low myoglobin concentration is a relevant marker of myocardial infarction in human blood plasma [8][9][10]. It is well known that the amplified SERS response of organic molecules could be obtained by depositing those on specially designed silver, gold or copper thin film substrates [11][12][13][14][15], as well as using silver or gold colloidal nanoparticles in solution [16][17][18][19].…”