A New Diagnostic Test for Acute Myocardial Infarction

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Abstract
The technique of radial immunodiffusion assay, in which the gel is impregnated with myoglobin antiserum, was used on urine samples from 60 patients with acute myocardial infarction, from 20 patients with chest pain due to ischemic heart disease without infarction, and from 20 normal subjects. In the group with an acute myocardial infarct, all but one patient showed significant levels of myoglobin (at or above 5 mg/ml) in urine samples taken within 48 hours after clinical onset of infarct. Urinary myoglobin to these levels never rose in the other two groups studied. Myoglobinuria appeared sooner, persisted longer, and was a much more accurate diagnostic test for infarction than serum levels of glutamic oxaloacetic transaminase, lactic dehydrogenase, or creatine phosphokinase. With these data, it will be possible to prepare a simple latex or agglutination test for myoglobinuria, to detect acute myocardial damage. (JAMA228:1251-1255, 1974)