Why the study?
Do CPK and LDH isoenzyme measurements provide better diagnostic discrimination for acute myocardial infarction than other standard serum enzymes?
Do CPK and LDH isoenzyme measurements provide better diagnostic discrimination for acute myocardial infarction than other standard serum enzymes?
The combined use of CPK and LDH isoenzyme assays provides superior discrimination for diagnosing acute myocardial infarction, rendering routine HBDH and SGOT measurements unnecessary in the CCU.
May refine MI diagnosis via combined isoenzymes; hypothesis-generating pending validation against modern biomarkers.
Total serum enzyme activity for creatine phosphokinase (CPK), alphahydroxybutyric dehydrogenase (HBDH), lactic dehydrogenase (LDH), and serum glutamic oxaloacetic transaminase (SGOT), as well as the isoenzymes of CPK and LDH, were measured on admission and for ten subsequent days in 100 patients admitted consecutively to a coronary care unit. On discharge, patients were classified by a cardiologist as either having or not having suffered an acute myocardial infarction (MI) on the basis of clinical and electrocardiographic criteria—without knowledge of the enzyme studies. The combined use of CPK and LDH isoenzyme levels provided the greatest laboratory discrimination between the two clinical groups (MI vs non-MI). The routine use of HBDH and SGOT levels can be abandoned in the setting of a coronary care unit if CPK and LDH isoenzyme assays are available. (JAMA232:145-147, 1975)
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R. S. Galen (1975) studied this question.
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