Serum Myoglobin : A Marker for Successful Thrombolytic Therapy in Acute Myocardial Infarction
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The material of this study comprised 30 patients with acute myocardial infarction as a test group and 10 normal cases with matched age and sex as a control group. The patients were divided into two groups : Group (I); 15 patients (10) males and (b) females with ages ranging between 41-72 years with a mean of 52.8 -I- 10.04 years, and Group (ID; 15 patients (9) males and (6) females with ages ranging between 50-62 years with a mean of 55.7 4- 3.68 years. Both groups (I) and (II) received the usual treatment of myocardial infarction, in addition group (II) patients received IV streptokinase as a thrombolytic therapy. All patients were subjected to thorough history and full clinical examination, the serum myoglobin levels were determined using the immunoturbidimetric method, serum CPK and SGOT, fasting and postprandial blood sugar and serum creatinine. A twelve leads ECG was done for every patient on admission, just after therapy and 6 hours after therapy (for streptokinase group). There was significant decrease in the previously elevated ST segment in most cases who had received intravenous streptokinase and in four treated cases the ST segment returned back to the base line. In this study there was a significant increase of serum myoglobin level in all patients of both groups (I) and (II) 6 hours after the onset of chest pain; meanwhile the peak serum myoglobin level recorded 6 hours after the onset of symptoms was higher in the first group as compared to the second group (884.46 ± 176.9 1( g/litre versus 486.93 ± 95.43 μ g/litre). On the other hand, patients receiving intravonous streptokinase therapy showed significantly low serum myoglobin levels than non streptokinase treated patients after 12 hours from the onset of symptoms. Also, myoglobin release stopped early in streptokinase treated patients than in non streptokinase treated patients, as control values were reached after 12 hours in contrast to 48 hours. respectively. There was strong correlation between serum myoglobin level and each of serum creatine phosphokinase (CPK) and serum oxalacetic transaminase (SGOT) level of both non streptokinase and streptokinase treated groups. This study illustrates the values of immunoturbidimetric assay of serum mvoglobin as a sensitive marker for early diagnosis of acute myocardial infarction and follow up of thrombolytic therapy for these patients.