Prognostic Value of Myoglobin in Non-ST Elevation Acute Coronary Syndromes

pp 185-191

Abstract

Background

Myoglobin is an early marker for myocardial necrosis. The prognostic value of myoglobin in patients with non-ST elevation acute coronary syndromes (ACS) within the five hours of symptoms is poorly defined. 

Objective

Our purpose was to determine the relationship of myoglobin levels at admission and 30 days death/MI among patients (pts) with non ST-elevation ACS. 

Research Design and Methods

A total of 366 pts with non ST-elevation ACS were enrolled in a prospective multicentric cohort study. Myoglobin levels were measured at hospital admission. A second serum sample at 12 hours of symptoms onset was used to measure troponin T, C-reactive protein, and CK-MB mass. Measurements were blinded and centralized. The study endpoint was death of MI at 30 days. Multivariable analysis was used tu assess the association between myoglobin and the clinical endpoint. 

Results

Median time from the onset of symptoms was 4 hours. Death or myocardial infarction occurred in 10.1 % of patients at 30 days. By stepwise logistic regression, the association of admission myoglobin and Death/MI at 30 days (OR 3.5 [95% CI: 1.6-7.6]) was independent of other clinical and biochemical markers. 

Conclusions

ACS patients with early elevated myoglobin are at higher risk for 30 day death and MI. Early myoglobin sampling added incremental information independently of standard clinical utilized markers.