[Non-invasive evaluation of coronary reperfusion using myoglobin: significance of quantitative and semi-quantitative...

We assessed the usefulness of myoglobin measured by latex agglutination methods as a parameter for successful reperfusion of the infarct-related artery. Plasma myoglobin levels were measured for 25 patients with acute myocardial infarction in whom thrombolysis and/or percutaneous transluminal coronary angioplasty (PTCA) were performed within 8 hours after the onset of symptoms. Blood samples were obtained before and 56 +/- 26 min (mean +/- SD) after commencing treatment. Plasma myoglobin levels were measured by quantitative and semi-quantitative latex agglutination methods, which required a procedure time of about 10 min. Coronary reperfusion was achieved by thrombolysis or PTCA in 22 cases (Group 1) but was not achieved by thrombolysis in 7 cases (Group 2). Before treatment (4.2 +/- 1.2 hours after the onset of symptoms), plasma myoglobin levels measured quantitatively and semi-quantitatively were 434 +/- 330 ng/ml and 4.6 +/- 4.2 fold, respectively. After treatment, the increased rate of myoglobin was significantly higher in Group 1 (8.4 +/- 7.5 and 9.2 +/- 7.1) than in Group 2 (1.8 +/- 0.5 and 1.7 +/- 0.5). Plasma myoglobin levels measured by quantitative and semi-quantitative latex agglutination methods showed a close correlation (r = 0.91, p < 0.01). In conclusion, measurement of plasma myoglobin levels by latex agglutination methods is a rapid and reliable way to confirm successful coronary reperfusion.