Diagnosis of acute myocardial infarction by detection of circulating cardiac myosin light chains

Hugo A. Katus, Tsunehiro Yasuda, Herman K. Gold, Robert C. Leinbach, H. William Strauss, Carol Waksmonski, Edgar Haber, Ban An Khaw

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62 Scopus citations

Abstract

A radioimmunoassay for human cardiac myosin light chains (CM-LC) was developed and evaluated as a selective diagnostic test for acute myocardial infarction (AMI). The assay had a sensitivity of 1.0 ng/ml (±2 standard deviations) in serum. Eighty-three patients with confirmed AMI all showed an elevated plasma concentration of CM-LC at some time during the course of their illness. Of 9 patients from whom early blood samples were obtained, 7 had diagnostic concentrations within 6 hours from the onset of chest pain. Only 2 had an elevated total creatine kinase level at this time. CM-LC concentrations peaked on days 2 to 4, but remained elevated in patients with large AMIs for more than 1 week. In preinfarction syndrome, 8 of 15 patients had elevated CM-LC levels at least once. Of 15 patients with stable angina pectoris, only 1 patient, who had congestive heart failure, showed elevated light chain levels. CM-LC levels were not detectable by this method in the sera of healthy persons (n = 72), patients with recent intramuscular injection (n = 3), or those with a variety of systemic illnesses (n = 14). In initial studies using an antiserum having 25% cross-reactivity between cardiac and skeletal muscle myosin light chains, 3 patients who had extensive skeletal muscle damage appeared to have elevated concentrations. Patients with this finding have not yet been examined with a more specific antiserum (8% cross-reactivity). The duration of CM-LC elevation in the circulation may be related to the extent of myocardial damage. This method may therefore provide a specific and sensitive diagnosis of early as well as late myocardial necrosis.

Original languageEnglish
Pages (from-to)964-970
Number of pages7
JournalAmerican Journal of Cardiology
Volume54
Issue number8
DOIs
StatePublished - 1 Nov 1984
Externally publishedYes

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