Time lapse from estimated onset of acute myocardial infarction to peak serum enzyme activity

Herlitz, Johan; Hjalmarson, Å; Waldenström, J

doi:10.1002/clc.4960070803

Cited by 10 publications

(3 citation statements)

References 25 publications

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“…This suggests that the S-T segment changes are a useful non-invasive marker of coronary artery patency. Previous studies have con firmed that release of creatine phosphokinase is accelerated following reperfusion [8,16]. In the absence of reperfusion, the peak value of creatine phosphokinase usually oc curs at 32-48 h [3].…”

Section: Discussionmentioning

confidence: 99%

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Thrombolytic Therapy in Acute Myocardial Infarction in the Elderly

Johnston

Dunn²,

Hogg³

et al. 1987

Gerontology

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Fifty-seven elderly patients (35 males, 22 females; age range 65–80 years, mean 70 years) with acute myocardial infarction received thrombolytic therapy within 8 h using either streptokinase or anisoylated plasminogen streptokinase activator complex. Coronary artery reperfusion was confirmed by early coronary arteriography. The overall reperfusion rate was 77%. Accurate non-invasive markers of reperfusion included: a rapid fall in the S–T segment elevation, an early peak of the creatinine phosphokinase enzyme curve and reperfusion arrhythmias. Clinical events suggesting early reocclusion occurred in 30%. Coronary arteriography was accompanied by local bleeding associated with the arterial puncture site in 2 patients and a cerebrovascular accident in 1 patient. Minor bleeding occurred in 6 other patients. In those where reperfusion occurred, the mortality at 1 month was 6.6% and in those who did not reperfuse or had early reocclusion 38%. At 1 year the figures were 10 and 46%, respectively.

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Section: Discussionmentioning

confidence: 99%

“…Other minor bleeding included coffee-ground vomiting, haematuria and pacemaker site haematoma, but none re quired blood transfusion. Bleeding compli cations other than minor oozing at vene puncture sites occurred therefore in 14% ( 8).…”

Section: Complications O F Therapymentioning

confidence: 99%

Thrombolytic Therapy in Acute Myocardial Infarction in the Elderly

Johnston

Dunn²,

Hogg³

et al. 1987

Gerontology

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“…Estimation of "time since onset ofinfarction" Some patients have difficulties in stating the time for onset of chest pain. Furthermore, the onset of chest pain might be an uncertain estimate for onset of infarction in the individual patient (198). Therefore, a "second opinion" from the computer, based on the pattern of biochemical markers, might be of value, e.g.…”

Section: Methodological Considerationsmentioning

confidence: 99%

Biochemical Markers of Myocardial Damage for Early Diagnosis and Prognosis in Patients with Acute Coronary Syndromes

Lindahl

1996

Upsala Journal of Medical Sciences

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In patients with suspected AMI. Monitoring of a combination of myoglobin and CK-MB or tn-T allowed ruling-in AMI within 2-3 hours and ruling-out AMI within 3-6 hours in almost all patients admitted with chest pain and a nondiagnostic ECG. This might have a large impact on the early handling and treatment of these patients. The neural network methodology, with monitoring of myoglobin, CK-MB and tn-T allowed, within the first three hours, reliable diagnosis/exclusion of AMI/MMD and prediction of infarct size in patients admitted with suspicion of AMI. The computer system was faster than clinicians. Thus, neural network methodology might be a useful support for the early assessment of patients with suspected myocardial infarction. In patients with unstable CAD. The risk of subsequent cardiac events is increased by increasing maximal levels of tn-T obtained during the initial 24 hours. Thereby a normal, a slightly elevated and a clearly elevated tn-T level identified a low, intermediate and high risk group, respectively, for MI or death. The tn-T level was an independent prognostic variable for MI or death in a multivariate analysis comparing other early available risk indicators. Furthermore, tn-T seemed to be superior to CK-MB (mass) for risk stratification. In patients able to perform a predischarge ET both the tn-T level and the ET response were independent prognostic indicators for MI or death. The combination of tn-T and the ET response allowed a further improved risk stratification. In patients with tn-T elevation at inclusion, prolonged dalteparin treatment was beneficial. However, in patients without tn-T elevation, long term dalteparin treatment had no protective effect. Thus, tn-T determination provides independent and important prognostic information in unstable CAD. In the selection of treatment strategy for the individual patient, this simple, inexpensive and early available biochemical test might be useful.

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Evaluation of Creatine Kinase and Creatine Kinase—MB for Diagnosing Myocardial Infarction

Lee¹

1987

Arch Intern Med

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Time lapse from estimated onset of acute myocardial infarction to peak serum enzyme activity

Cited by 10 publications

References 25 publications

Thrombolytic Therapy in Acute Myocardial Infarction in the Elderly

Thrombolytic Therapy in Acute Myocardial Infarction in the Elderly

Biochemical Markers of Myocardial Damage for Early Diagnosis and Prognosis in Patients with Acute Coronary Syndromes

Evaluation of Creatine Kinase and Creatine Kinase—MB for Diagnosing Myocardial Infarction

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