Abstract:

Acute Myocardial infarction AMI occurs during the period when circulation to a region of the heart is obstructed and necrosis ensues. The objective of this study was to estimate the levels of serum Myoglobin and enzymes as cardiac marker for diagnosis of early Myocardial Infarction. This was case control hospital based study involving 130 patients admitted to Elshaab Teaching Hospital and Sudan Heart Center, suffering chest pain, wherein all patients were taken immediately to Coronary Care Unit CCU . 30 apparently healthy people were enrolled as control. This study was conducted between March and October 2010. The age ranged between 39-60 years . Blood samples were collected for the estimation of Myoglobin using fully automatic immunoanalyzer and cardiac enzymes were measured using Spectrophotometer. The mean levels of myoglobin concentration in different patients at admission and after 24 hrs of admission to the hospital was 563 ng/ml and 34 ng/ml for patients and control respectively. The level remained higher even after 24 hrs of admission 414 ng/ml . Creatine kinase dramatically elevated within the first 24 hrs in all patients admitted to hospital during 6, 10, 20, 24 and 48 hrs following chest pain attack. CK-MB gradually elevated in patients admitted 6, 10, 20, 24 and 48 hrs from chest pain attack, reaching a peak after 24 hrs of chest pain attack, and then CK-MB levels declined to normal values after 48 hrs. The LDH level exhibited increase levels in patients admitted 6, 10, 20, 24 and 48 hrs from chest pain attack, and the levels persisted all through 24 hrs irrespective of the time admission to the hospital following chest pain. AST level was not elevated after 6 hrs or 10 hrs following the chest pain attack, but a dramatic elevation was seen after 24 hrs following hospital admission, however, increased levels of AST was noticed in patients admitted to hospital after 24 or 48 hrs following the attack. The levels were within the normal value in patients admitted after 48 hrs of the chest pain attack, and remain so following 24 hrs of admission. This study indicated that Myoglobin and CK-MB are more sensitive cardiac markers compared to total CK, LDH and AST for the diagnosis of Myocardial Infarction.

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