Circulating cardiac myosin light chains in patients with angina at rest: Identification of a high risk subgroup

• Published in: Journal of the American College of Cardiology Vol. 11; no. 3; pp. 487 - 493
• Main Authors: Katus, Hugo A., Diederich, Klaus W., Hoberg, Eike, Kübler, Wolfgang
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.1988; Elsevier Science
• Subjects: Adult; Aged; Angina Pectoris, Variant - diagnostic imaging; Angina Pectoris, Variant - enzymology; Angina Pectoris, Variant - physiopathology; Biological and medical sciences; Cardiology. Vascular system; Coronary Angiography; Coronary heart disease; Electrocardiography; Female; Heart; Humans; Male; Medical sciences; Middle Aged; Myocardial Infarction - blood; Myocardium - enzymology; Myosin-Light-Chain Kinase - blood; Prognosis; Rest; Risk Factors; Time Factors; Human; Proteins; High risk; Short chain; Prognosis; Myosin; Cardiovascular disease; Serum; Angina pectoris; Coronary heart disease
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/0735-1097(88)91521-5

To detect myocardial cell damage, serum samples of 42 consecutive patients with angina at rest were screened for cardiac myosin light chains, which were detected in 22 patients (52%). In 17 of these patients there was a persistent release of myosin light chains lasting until the 4th hospital day, whereas in 7 patients myosin light chains were only detectable during the initial 24 h after admission. The presence of myosin light chains correlated with signs of ischemia in the electrocardiogram (ECG) (p < 0.05) and with the extent of coronary artery narrowing (p < 0.05). Cardiac myosin light chains were elevated in serum only if there was a ≥75% diameter narrowing in at least one major vessel. In all five patients who developed transmural myocardial infarction during the course of their hospital stay, myosin light chains were detectable ≥28 h before the diagnosis of myocardial infarction could be established by ECG criteria and conventional serum enzymes. Thus the detection of circulating cardiac myosin light chains enables one to identify a subgroup of patients with angina at rest having more severe coronary artery disease with a worse outcome.