Why the study?
Does plasma myoglobin provide better diagnostic sensitivity and specificity than creatine kinase-MB for the early diagnosis of acute myocardial infarction in patients presenting with chest pain?
Does plasma myoglobin provide better diagnostic sensitivity and specificity than creatine kinase-MB for the early diagnosis of acute myocardial infarction in patients presenting with chest pain?
Plasma myoglobin is more sensitive than creatine kinase-MB for the early diagnosis of acute myocardial infarction within 6 hours of chest pain onset.
Myoglobin may aid early AMI diagnosis; hypothesis-generating and requires prospective validation before practice change.
Serum and plasma myoglobin and creatine kinase-MB catalytic activity were analysed in 157 patients admitted within 2 hours of the onset of chest pain (58 were retrospectively recognized as acute myocardial infarction). Serum and plasma values were highly correlated for both myoglobin and creatine kinase-MB. Plasma myoglobin appeared to be more sensitive than creatine kinase-MB for the early diagnosis of acute myocardial infarction; using a cut-off value of 100 micrograms/l, 90% of acute myocardial infarction cases were correctly recognized by plasma myoglobin 6 hours after the onset of chest pain, with a diagnostic specificity of 100% for non-acute myocardial infarction chest pain subjects. Plasma creatine kinase-MB showed a diagnostic sensitivity of 62% and a diagnostic specificity of 95% in the same group of patients. We suggest the inclusion of the plasma myoglobin immunonephelometric assay together with plasma creatine kinase-MB activity analysis in protocols for the early diagnosis of acute myocardial infarction.
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Castaldo et al. (1994) studied this question.
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