Prediction of myocardial infarct size from early serum myoglobin observations

Different possibilities to predict infarct size were analysed. The basic method was the fitting of a mathematical model to serial serum myoglobin concentration values from the very early phase of infarction. Correlation was performed with infarct size estimated from the complete serum curves of 53 patients. An observation period up to and including the serum peak value (on the average 6.8 h after onset) was required in order to give a well-determined value of infarct size. A correlation coefficient of r = 0.85 (n = 38) was then obtained. The serum peak concentration value of myoglobin correlated even better (r = 0.89). The initial slope of the serum curve (obtained on the average 4.3 h after onset of symptoms) also correlated well to infarct size (r = 0.80; n = 53). In conclusion, estimation of infarct size appears to be as good with the serum peak value of myoglobin as with model-based parameters. The most useful measure for early prediction of infarct size could be the initial slope of the serum curve.