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European Heart Journal 1985 6(2):114-119;
Copyright © 1985 by the European Society of Cardiology.
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© 1985 The European Society of Cardiology

Complexity of enzyme release during acute myocardial infarction in a controlled study with early nifedipine treatment

E. LOOGNA*, C. SYLVÉN{dagger},, T. GROTH{ddagger} and L. MOGENSEN{dagger}

*Department of Internal Medicine, Nacka Hospital
{dagger}Departments of Internal Medicine and Clinical Chemistry, Karolinska Hospital Stockholm, Sweden
{ddagger}Unit for Biomedical System Analysis, Uppsala University Uppsala, Sweden

Received 21 May 1984; revised 14 November 1984; .

Christer Sylvén MD, Department of Internal Medicine, S:t Erik's Hospital, S-112 82 Stockholm, Sweden.

Abstract

Fifty-seven consecutive patients with acute myocardial infarction (AMI), admitted to a coronary care unit (CCU) within 6 h from onset of symptoms were included in the study and randomly allocated to nifedipine treatment or placebo. The 23 patients in the treatment group received 10 mg nifedipine orally at the onset the study, after 30 min, and then every 6 h. Placebo was given to the 34 patients in the control group. The study was double blind. Serum time-activity curves for creatine-kinase-MB (CK–MB) and myoglobin (MG) were established from frequent determinations.The two patient groups did not differ significantly regarding average cumulative MG and CK–MB release. In both groups the range was wide, with the largest maximal individual release about 30 times larger than smallest. In most patients the enzyme release occurred stepwise, resulting in two or more separate peaks. In the treatment group significantly fewer patients had multiple peaks of MG (P<0.05) and CK–MB (P<0.025) release. The initial peaks had a longer duration in the treatment group and total release tended to stop earlier. In the control group a highly significant correlation between cumulative MG and CK–MB release was obtained, while in the treatment group no such correlation was observed.

In conclusion, oral administration of nifedipine during acute myocardial infarction appears to influence pattern of enzyme release, although no effect on the total cumulative release could be demonstrated.

Key Words: Acute myocardial infarction • nifedipine • myoglobin • CK–MB • multiphasic enzyme release • infarct size


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