Myocardial reperfusion can be predicted by myoglobin/creatine kinase ratio of a single blood sample obtained at the time of admission

Abe, Jun‐ichi; Yamaguchi, Tetsu; Isshiki, Takaaki; Naka, Hajime; Taguchi, Junichi; Ishizaka, Nobukazu; Kurokawa, Kiyoshi; Saeki, Fumihiko; Ishizaka, Yuko; Ui, Katsuto; Ikari, Yuji; Somitsu, Yasunari; Hashimoto, Hideki; Kashida, Mitsuo

doi:10.1016/0002-8703(93)91040-l

Cited by 14 publications

(4 citation statements)

References 14 publications

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“…The noninvasive diagnosis of coronary reperfusion using ECG ST elevation or serum enzyme activity is accurate, but requires serial evaluation, which is not ideal for the management of patients with AMI. 13,15,[25][26][27] The present study showed a practical and noninvasive approach for the approximate but quick evaluation of the absence of adequate coronary reperfusion or identification of patients with potential benefits by emergent therapeutic procedures such as intravenous thrombolysis or percutaneous coronary intervention.…”

Section: Clinical Applicationmentioning

confidence: 91%

Increased Tei Index Suggests Absence of Adequate Coronary Reperfusion in Patients With First Anteroseptal Acute Myocardial Infarction

Kuwahara

Takasaki

Yuasa

et al. 2006

Circ J

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Section: Clinical Applicationmentioning

confidence: 91%

Increased Tei Index Suggests Absence of Adequate Coronary Reperfusion in Patients With First Anteroseptal Acute Myocardial Infarction

Kuwahara

Takasaki

Yuasa

et al. 2006

Circ J

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“…Darüber hinaus beeinflussen Veränderungen der Die Identifikation jener Patienten, bei denen bereits eine spontane Reperfusion zum Zeitpunkt der Klinikaufnahme aufgetreten ist, gelingt ebenfalls mit einer Relationsanalyse der Serumkonzentration kardialer Marker. So besitzt eine um mehr als das Fünffache der CK-Konzentration erhöhte Myoglobinkonzentration zum Zeitpunkt der Klinikaufnahme eine 75%ige Sensitivität und eine 96%ige Spezifität für den Nachweis einer spontanen Reperfusion [1]. Allerdings soll nicht unerwähnt bleiben, dass eine Differenzierung zwischen rascher (TIMI-III-Fluss) und verzögerter (TIMI-II-Fluss) vollständiger Reperfusion mittels biochemischer Marker nicht möglich ist [14].…”

Section: Abbildung 3 Kardiale 14-tage-mortalität Bei Akutem Koronarsunclassified

Biochemische Marker bei ischämischen und nicht ischämischen Myokardschädigungen

Herrmann¹,

Volbracht²,

Haude³

et al. 2001

Med Klin

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“…Infarct artery reflow is associated with an abrupt and impressive increase in both the magnitude and rate of myoglobin release. A >2.0-fold increase in myoglobin concentration over 60 minutes or a myoglobin/CK ratio >5.0 within 6 hours of symptom onset are highly predictive of recanalization [23,24].…”

Section: Biochemical Testingmentioning

confidence: 99%

ECG monitoring, biochemical testing, and anticoagulation assessment

O’Gara

1996

J Thromb Thrombol

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Although ancillary tools such as echocardiography and radionuclide imaging are available for emergency room use, clinicians continue to rely most often on the history, electrocardiogram (ECG), and serologic markers to establish the diagnosis of acute myocardial infarction (MI). A high clinical index of suspicion is necessary in situations in which the presentation might be atypical, for example, in the elderly or diabetic patient. Any chest pain should be further characterized within the context of the patient's risk profile and its particular attributes fully delineated. The ECG is then scrutinized for the presence of new ischemic changes, whereby an appropriate management strategy is initiated. Acute reperfusion therapy is to be considered for patients with pathologic STsegment elevations in two or more contiguous leads as well as for patients with new left bundle branch block. Note should also be made of the many ECG features that provide early prognostic information, such as the magnitude and extent of the ST-segment elevation, the presence of right-sided or precordial ST-segment deviations in the setting of inferior injury current [1,2], and the subsequent development of a Q-wave versus non-Q-wave pattern [3]. The amplirude of ST-segment elevations may vary considerably over the first 3 hours following thrombolytic therapy as a reflection of the competing forces of clot lysis and rethrombosis. In these settings, continuous or frequent monitoring of ECG leads corresponding to the infarct zone is highly recommended. Standard 12-lead tracings obtained at widely disparate intervals are relatively less informative [4,5].The noninvasive assessment of infarct-artery patency following thrombolytic therapy is a critical feature of early management. Failure of timely reperfusion is an indication for rescue angioplasty (PTCA) which, despite its potential shortcomings, is to be pursued, especially in the setting of hemodynamic instability, whenever appropriate thcilities are available. Early recanalization with normal (TIMI grade 3) flow is the primary goal of any reperfusion strategy. Noninvasive indices of vessel patency include resolution of chest pain, improvement in ST-segment elevation, and early serologic marker release. Because the latter phenomenon is usually appreciated retrospectively, attention is initially focused on the former two events.When examined in isolation, the improvement or resolution of chest pain is at best an imprecise gauge of vessel patency following thrombolysis. In an analysis of 386 patients from the Thrombolysis and Angioplasty in Myocardial Infarction (TAMI 1) trial, Califf et al. reported that 87% of patients with complete and 71% of patients with partial resolution of chest pain had a patent artery at 90 minutes, as did 60% of the patients with unchanged or worsening pain [6]. Analysis of the change in ST-segment elevation proved more discriminatory than chest pain status in a logistic regression model. Indeed, 96% of patients with complete and 84% of patients with partial resolution ...

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Myocardial reperfusion can be predicted by myoglobin/creatine kinase ratio of a single blood sample obtained at the time of admission

Cited by 14 publications

References 14 publications

Increased Tei Index Suggests Absence of Adequate Coronary Reperfusion in Patients With First Anteroseptal Acute Myocardial Infarction

Increased Tei Index Suggests Absence of Adequate Coronary Reperfusion in Patients With First Anteroseptal Acute Myocardial Infarction

Biochemische Marker bei ischämischen und nicht ischämischen Myokardschädigungen

ECG monitoring, biochemical testing, and anticoagulation assessment

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