Rocket Immunoelectrophoresis of myoglobin in urine in patients with myocardial infarction

A rocket immunoelectrophoretic method with prepared antisera to rabbit myoglobin has been developed to study the urinary myoglobin excretion in patients with acute myocardial infarction. The method is able to detect a minimum urinary myoglobin concentration of 1—2 mg/l. Urine specimens from 156 patients admitted to the coronary care unit with a provisional diagnosis of acute myocardial infarction were analysed. Seventysix patients proved to have documented myocardial infarction. Twelve of them had at least one positive determination. Four of the 80 without infarction had myoglobinuria. 15 hours elapsed from the time of the initial event of chest pain to the first positive urine specimen. No statistically significant difference could be demonstrated in the mortality in patients with infarction with and without myoglobinuria. The present authors were unable to confirm the high incidence of myoglobinuria in acute myocardial infarction, described previously in other works. The possibility of renal tubular reabsorption of myoglobin as an explanation of this descrepancy is mentioned. Our preliminary results with the estimate of myoglobin in serum with a radioimmunoassay seem to valuable as an index of infarct size.