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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.


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1437-4331
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Glycogen phosphorylase BB in acute coronary syndromes

Dirk Peetz1 / Felix Post2 / Helmut Schinzel3 / Rosemarie Schweigert4 / Caroline Schollmayer5 / Katrin Steinbach6 / Francesco Dati7 / Franz Noll8 / Karl J. Lackner9

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Corresponding author: PD Dr. Dirk Peetz, Institute of Clinical Chemistry and Laboratory Medicine, Johannes Gutenberg-University, Langenbeckstraße 1, 55101 Mainz, Germany Phone: +49-6131-172632, Fax: +49-6131-176627,

Citation Information: Clinical Chemical Laboratory Medicine. Volume 43, Issue 12, Pages 1351–1358, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2005.231, November 2005

Publication History

Received:
August 1, 2005
Accepted:
September 27, 2005
Published Online:
2005-11-28

Abstract

The diagnosis of myocardial damage is preferably based on measurement of the cardiac-specific troponins. However, there is an emerging need for early, specific cardiac markers. One potential candidate is the glycogen phosphorylase BB isoenzyme (GPBB). We investigated the use of a new, commercially available GPBB ELISA assay in 61 patients presenting with an acute coronary syndrome (37 acute myocardial infarction, 24 unstable angina pectoris) in comparison to established cardiac markers such as troponin T, creatine kinase isoenzyme MB (CKMB) mass, and myoglobin. Blood samples were obtained on arrival, as well as 1, 2, 3, 4, 8, 12 and 24 h later. GPBB plasma concentrations were elevated in 90.9% of patients 1 h after onset of chest pain and increased to 100% at 4–5 h. Within the first 6 h, GPBB showed the highest sensitivity (95.5–100%) and high specificity (94–96%) compared to myoglobin (85–95% sensitivity) and CKMB mass (71.4–91.3% sensitivity). As expected, troponin T showed high specificity (100%) and sensitivity >95% later in the time course (≥3 h). In un-stable angina pectoris patients, a very high rate of elevated GPBB was observed (93.9% at 3 h) compared to myoglobin (66.7%). Cardiac troponin T and CKMB were only elevated in 33.8% and 55.0% of these patients, respectively. In conclusion, GPBB is a promising marker for the early diagnosis of acute coronary syndromes and could probably act as a marker of ischemia. However, further studies on specificity and development of a fast, automated assay are necessary before GPBB can be recommended as a routine diagnostic tool.

Keywords: acute myocardial infarction; glycogen phosphorylase BB; myocardial ischemia; sensitivity and specificity; unstable angina pectoris

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