Lysosomal and cytosolic enzyme release in acute myocardial infarction: effects of methylprednisolone.

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Abstract
Venous blood samples were obtained from 45 patients with myocardial infarction. Of these patients, 10 received 25 mg/kg methylprednisolone sodium succinate i.v. within 4 h of onset of chest pain. Plasma creatine kinase (CK) and its MB [myocardial-band]-isoenzyme activities were assayed. A lysosomal enzyme, N-acetyl-.beta.-glucosaminidase (NAG) was assayed. In control patients, the peak activity of CK occurred at 21.3 .+-. 1.3 after onset of chest pain, and peak activities of CK-MB and NAG occurred at 18.1 .+-. 1.6 h and 18.0 .+-. 1.0 h, respectively. Peak values of CK and NAG activities were related exponentially and peak CK-MB and NAG activities were related linearly. In patients who received methylprednisolone the peak enzyme activities were delayed until 27.1 h for CK, 27.0 h for CK-MB and 27.3 h for NAG. The mean peak values for NAG activity was considerably lower in treated patients and the activities of the lysosomal enzyme and CK or CK-MB were not related. These findings agree with previous results suggesting that methylprednisolone can delay tissue damage and stabilize lysosomal membranes during acute myocardial ischemia.