A Rapid Assay for the Quantification of Myoglobin: Evaluation and Diagnostic Relevance in the Diagnosis of Acute Myocardial Infarction

We evaluated a new, fast, quantitative, turbidimetric assay (TurbiTimeSystem, Behringwerke AG, Marburg, Germany) for the determination of myoglobin concentration in serum. Within-run imprecision (n = 10) was < 3.7% in controls ranging from 81.1 to 621.4 micrograms/l and between-day imprecision (n = 50) was < 6% in controls ranging from 69.5 to 623.4 micrograms/l. The assay is linear over the measuring range and interfering substances such as bilirubin, haemoglobin or haptoglobin do not interfere but triacylglycerol-rich samples are only measurable after brief ultracentrifugation. EDTA- or citrate-treated samples display depressed myoglobin concentration when compared with serum samples. The upper reference limit for apparently healthy individuals (n = 100, 50 female and 50 male) is 61.5 micrograms/l. Comparison with nephelometry revealed a good correlation (r = 0.982) between the two methods with the regression equation: turbidimetric assay = 5.53 + 1.02x nephelometric assay. Serial determination of myoglobin concentration and creatine kinase in 18 patients with proven acute myocardial infarction showed in general an equal diagnostic significance for both analytes. In the first 4 hours after onset of chest pain, the determination of myoglobin can have an advantage, since it is released into the blood stream at an earlier stage, but thereafter myoglobin can lead to false negative diagnosis. Therefore, determination of creatine kinase and its isoenzyme MB is still the diagnostic strategy of choice in the diagnosis of acute myocardial infarction.