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Lactate dehydrogenase iso enzymes and myo cardial infarction in patients undergoing coronary bypass surgery an excellent correlation

, : Lactate dehydrogenase iso enzymes and myo cardial infarction in patients undergoing coronary bypass surgery an excellent correlation. American Heart Journal 92(5): 584-588

To evaluate the efficacy of LDH [lactic dehydrogenase] isoenzymes in the detection of myocardial infarction in patients undergoing coronary bypass surgery, 73 patients were studied preoperatively and postoperatively by ECG, CPK [serum creatinine phosphokinase], SGOT [serum glutamic oxaloacetic transaminase], total serum LDH and LDH isoenzyme measurements. A reversal of the LDH1:LDH2 ratio was considered indicative of myocardial necrosis. Accordingly, the patients were separated into 2 groups: Group A (23 patients) who demonstrated an LDH1:LDH2 ratio exceeding 1.0 and Group B (50 patients) who failed to reveal an LDH1:LDH2 reversal. The 2 groups were similar in regard to preoperative evaluation and operative procedure performed. The postoperative ECG findings were significantly different. In Group A, 18 of 23 patients (78%) developed significant new Q waves. This occurred in only 1 patient in Group B. Significant arrhythmias occurred in 70% of the patients in Group A as compared to 14% of those patients in Group B. Severe congestive heart failure and/or clinical evidence of shock occurred in 39% of Group A patients and none in Group B. The reversal of the LDH1:LDH2 ratio was a valuable tool for the evaluation of postoperative myocardial infarction.


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