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The Journal of Thoracic and Cardiovascular Surgery, Vol 69, 851-857, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Serum enzyme data in diagnosis of myocardial infarction during or early after aorta-coronary saphenous vein bypass graft operations

JL Assad-Morell, RB Wallace, LR Elveback, GT Gau, DC Connolly, DA Barnhorst, JR Pluth and GK Danielson

In 397 cases, serum glutamic oxaloacetic transaminase (GOT) and creatine phosphokinase (CPK) values were determined on the first, second, and third days after aorta-coronary artery saphenous vein bypass graft operations. Electrocardiographic (ECG) or vectorcardiographic (VCG) evidence of postoperative transmural infarction was found in 48 cases. Multivariate analysis indicated that GOT and CPK concentrations on day 1 had substantial discriminatory value regarding infarction. Discrimination by GOT values was not significantly improved by addition of CPK. Of the 61 cases positive by GOT values measured 1 day postoperatively (greater than 100 U. per liter; normal smaller than 24), 32 (52 percent) were negative by ECG or VCG; of the 336 cases negative by GOT, 19 (6 percent) were positive by ECG or VCG. GOT and CPK values increased with the number of vessels grafted and with the use of ventricular rather than atrial vents. Total serum enzyme values lack specificty in diagnosis of transmural infarction after the saphenous vein bypass operation.


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Copyright © 1975 by The American Association for Thoracic Surgery.