Author:
Vasudevan G,Mercer D W,Varat M A
Abstract
Lactic dehydrogenase (LD) isoenzymes were determined by a rapid, simple technique and their utility in the diagnosis of acute myocardial infarction (AMI) was evaluated. LD isoenzymes were separated by ion-exchange column chromatography using DEAE-Sephadex. The cardiac fractions (LD-1 and LD-2) were measured separately on an Abbott ABA-100 analyzer and ratio of LD isoenzyme 1 to LD isoenzyme 2 (LD1:2) calculated. Daily serum samples were obtained from 100 patients selected only for a history of chest pain of abrupt onset. In 47 patients whose diagnosis was acute myocardial infarction (AMI), confirmed by typical clinical presentation and typical rise in cardiac-specific creatine kinase isoenzyme (MB(, peak LD1:2 ranged from 0.77 to 2.26. In 44 patients without AMI, peak LD1:2 ranged from 0.25 to 0.76. In two patients with electrocardiographic changes chest pain occurred two and five days previously; there was no rise in MB, but LD1:2 was elevated. Four patients with small AMI had no rise in LD1:2. Three more patients (one with active hemolysis) had false positive results. Thus, there was a sensitivity of 96% and a specificity of 97% when the cut-off point was LD1:2 = 0.76. LD1:2 is not quite as sensitive or specific as MD, but the ratio allows for the diagnosis of infarction in cases where MB has already returned to normal.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Cited by
58 articles.
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