The Value of Serum Myoglobin Determinations in the Early Diagnosis of Acute Myocardial Infarction

Abstract

Myoglobin has been measured in sera from 305 consecutive patients with suspected acute myocardial infarction (AMI) to study the clinical value in relation to other diagnostic methods. On admission the frequency of false negative (i.e. the diagnostic sensitivity) myoglobin values was 28% in the AMI group as compared with 60% for serum creatine kinase (CK) and 46% for serum aspartate aminotransferase (ASAT). Four hours after admission the corresponding figures were 2, 31 and 29%. This makes the diagnostic sensitivity of the myoglobin test 0.98, which is significantly higher (p<0.001) than that of the two enzyme tests. The predictive value of a negative myoglobin test was 0.97 and also significantly higher (p<0.001 and p<0.01) than for CK and ASAT. S‐myoglobin was further related to the number of complications and the prognosis of the patients, and high levels appeared to be an unfavourable sign, particularly in combination with an anterior wall infarct. This study has demonstrated and confirmed the superior diagnostic sensitivity of myoglobin determination in early AMI. The inclusion of S‐myoglobin in the routine diagnosis of AMI warrants serious consideration.

Early Diagnosis of Acute Myocardial Infarction with a Rapid Latex Agglutination Test for Semi‐quantitative Estimation of Serum Myoglobin

“…Our data also confirmed the previously reported lack of specificity of S-myoglobin (8,10,13). Like Chapell et al (21), we found the latex agglutination test reliable for the determination of elevated levels of S-myoglobin under these optimized laboratory conditions.…”

“…S-Myoglobin concentration rises significantly in most AM1 patients within 3 hours after onset of the acute episode and several hours in advance of serum enzymes (7)(8)(9)(10)(11). With a diagnostic and a nosographic sensitivity of both 0.94 and an F F" AM1 of 0.06, this study has confirmed the usefulness of S-myoglobin RIA as a sensitive indicator of AM1 (3, 7-11, 17).…”

“…Elevation of serum (S) myoglobin might provide such a parameter. In AM1 patients an increase in S-myoglobin is found a few hours after the onset of symptoms, preceding the increase in serum enzymes with several hours (7)(8)(9)(10)(11).…”

In Search for Novel Biomarkers of Acute Coronary Syndrome

“…The main advantage of myoglobin is early detection of patients with AMI (Gibler et al, 1987, Roxin et al, 1984. The NACB Laboratory Medicine Practice Guidelines have recommended myoglobin in addition to cardiac troponins (cTn) for the diagnosis of AMI patients who present within the 6 hours of onset of symptoms (Apple et al, 2007).…”

Prognostic value of serum myoglobin in patients after cardiac surgery

“…One major clinical point of interest, e.g., during AMI, is that myoglobin reaches its peak serum level hours before other heart-muscle specifi c markers, such as creatine phosphokinase isoenzyme MB (CK-MB) [10][11][12][13]. Consequently, serum myoglobin has found its place in clinical routine as a determinant in diagnosing AMI [14] or acute coronary syndromes [15].…”