LDH isoenzymes and myocardial infarction in patients undergoing coronary bypass surgery: An excellent correlation

Mohiuddin, Syed M.; Raffetto, Joseph D.; Sketch, Michael H.; Lynch, Joseph D.; Schultz, Richard D.; Runco, Vincent

doi:10.1016/s0002-8703(76)80077-4

Cited by 7 publications

(5 citation statements)

References 20 publications

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“…This possibility was supported by Ben-Zvi et al188 They studied 69 consecutive patients an average of ten months post ACBG; there was progression of disease in only 17% of the grafted vessels and 6% of the nongrafted vessels. In contrast, these same investigators observed progression of the disease after 27 months in 56% of 16 randomly selected symptomatic patients treated medically.…”

Section: Acceleration Of the Atherosclerotic Process In The Native CImentioning

confidence: 85%

The first decade of aortocoronary bypass grafting, 1967-1977. A review.

McIntosh¹,

Garcia²

1978

Circulation

194

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SUMMARY Despite a decade of experience with aortocoronary bypass grafting embracing 300,000 or more operations, indications for its use remain controversial. The controversy persists because of a lack of adequate controls with which to compare the clinical course of operated patients; only 1248 have been reported who have been studied in a carefully controlled and random manner.Benefit has been claimed frequently by comparing the course of patients treated surgically with medically treated patients followed the decade before. Such comparisons are not valid in view of the well documented changes in the natural history of coronary artery disease that have been occurring during the last decade.Despite a low operative mortality and rate of graft closure, available data in the literature do not indicate that initial symptomatic improvement necessarily persists, or that myocardial infarctions, arrhythmias, or congestive heart failure will be prevented, or that life will be prolonged in the vast majority of operated patients."It is much easier to write upon a disease than upon a remedy. The former is in the hands of nature and a faithful observer with an eye to tolerable judgment can not fail to delineate a likeness; the latter will ever be subject to the whim, the inaccuracy and the blunder of man."William Withering"

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Section: Acceleration Of the Atherosclerotic Process In The Native CImentioning

confidence: 85%

The first decade of aortocoronary bypass grafting, 1967-1977. A review.

McIntosh¹,

Garcia²

1978

Circulation

194

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“…Postoperative electrocardiographic evidence of acute myocardial infarction occurs in 6 to 30 per cent of the patients undergoing aorto-coronary bypass grafting (Hultgren et a!., 1971;Bolooki etal., 1972;Alderman et al, 1973;Bolooki et al, 1973;Brewer etal., 1973;Oldham et al, 1973;Espinoza et al, 1974;Ghani et al, 1974;Rose et al, 1974;Codd et al, 1975;Mohiuddin et al, 1976;Codd et al, 1977;Hultgren et al, 1977;Klein et al, 1977;Warren et al, 1977). In patients undergoing valvular replacement 0 to 14 per cent developed electrocardiographic abnormalities characteristic of acute myocardial infarction (Ghani et al, 1974;Rose et a!., 1974;Hultgren et al, 1977;Klein et al, 1977).…”

Section: Discussionmentioning

confidence: 99%

“…Other criteria sensitive for myocardial injury, either ischaemia or infarction, that can be used are rises in plasma enzymes (Shirey et al, 1970;Hultgren et al, 1971;Alderman et al, 1973;Bolooki et al, 1973;Ghani et al, 1974;Neutze et al, 1974;Rose et al, 1974;Hultgren et al, 1977). More recently, rises in isoenzymes of CK (CKMB) and LDH (LDH-1) in plasma are used for the diagnosis of myocardial injury Oldham et al, 1973;Codd et al, 1975;Mohiuddin et al, 1976;Pyle et al, 1976;Codd et al, 1977;Warren et al, 1977). Both CKMB and LDH-1 are raised in myocardial infarction, or more generally in myocardial injury.…”

Section: Discussionmentioning

confidence: 99%

“…The cardiospecific isoenzyme of CK (CKMB) has been used successfully for the detection of acute myocardial infarction in patients in coronary care units (Konttinen and Somer, 1972;Roe et al 1972;Roberts et al, 1975a) and in patients undergoing aortocoronary bypass surgery Oldham et al, 1973;Pyle et al, 1976;Warren et al, 1977). Likewise the 'heart' fraction of LDH (LDH-1) has been proved to be valuable in the detection of acute myocardial infarction postoperatively (Codd et al, 1975;Mohiuddin et al, 1976;Codd et al, 1977).…”

mentioning

confidence: 99%

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Recognition and quantification of myocardial injury by means of plasma enzyme and isoenzyme activities after cardiac surgery.

Laarse¹,

Davids²,

Hollaar³

et al. 1979

Heart

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SUMMARY Serial plasma enzyme determinations were carried out in 32 patients who underwent cardiac surgery with the aid of extracorporeal circulation. Plasma creatine kinase (CK), the cardiospecific isoenzyme of CK (CKMB), and alpha-hydroxybutyrate dehydrogenase (HBDH) were determined from the onset of surgery up to 100 to 120 hours after operation. From the plasma enzyme activities, the total amount of enzyme released by the injured heart into the circulation could be calculated using mathematical equations solved numerically by means of a computer. The calculated amount of CK, CKMB, and HBDH released by the heart correlated well with (1) postoperative mortality, and (2) peak activities of the respective enzymes. The calculated amount of any of the 3 enzymes released showed poor or no correlation with (1) electrocardiographic criteria of myocardial infarction, (2) duration of cardiopulmonary bypass, and (3) duration of total aortic cross-clamping.This study shows that the extent of myocardial injury after surgery can be assessed quantitatively using the calculated amounts of enzyme released, as well as using peak plasma activities of CKMB and HBDH.

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“…The incidence of electrocardiographic, vectorcardiographic, scintillographic and enzymatic findings consistent with perioperative AMI, in association with coronary artery by-pass surgery, has ranged from 6 to 40% in different series (Bolooki et al, 1973;Schrank et al, 1974;Mohiuddin et al, 1976;Righetti et al, 1977). In our surgically treated group s-ASAT and s-ALAT were obtained perioperatively.…”

Section: Discussionmentioning

confidence: 99%

A High Risk Subgroup of Patients with Unstable Angina Pectoris Treated Medically or Surgically

Nordlander

Nyquist

1979

Scandinavian Journal of Thoracic and Cardiovascular Surgery

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Among patients consecutively admitted to a coronary care unit (CCU) without a subsequent diagnosis of acute myocardial infarction (AMI), a subgroup fo unstable angina was selected, defined as continued episodes of angina at rest during a 48-hour period, despite medical treatment in the CCU. During a four-year period, 15 patients fulfilled these criteria. Eight patients were medically treated, seven of whom developed an AMI with three subsequent deaths. Six of the infarcts occurred within eight days of admission. In six patients, fulfilling the criteria, surgical treatment was performed. Angiography and surgery in this group were associated with low incidences of myocardial infarction, late infarction and death. In one patient, surgery was declined due to unfavourable anatomical conditions. This patient subsequently developed an AMI and died. It is concluded that the combination of recent onset of angina and continued episodes of angina at rest, despite medical treatment, selects a high risk subgroup of unstable angina. Acute coronary angiography and surgery ought to be considered in this subgroup.

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LDH isoenzymes and myocardial infarction in patients undergoing coronary bypass surgery: An excellent correlation

Cited by 7 publications

References 20 publications

The first decade of aortocoronary bypass grafting, 1967-1977. A review.

The first decade of aortocoronary bypass grafting, 1967-1977. A review.

Recognition and quantification of myocardial injury by means of plasma enzyme and isoenzyme activities after cardiac surgery.

A High Risk Subgroup of Patients with Unstable Angina Pectoris Treated Medically or Surgically

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