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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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Volume 43, Issue 12 (Dec 2005)

Issues

Glycogen phosphorylase BB in acute coronary syndromes

Dirk Peetz
  • Institute of Clinical Chemistry and Laboratory Medicine, Johannes Gutenberg-University, Mainz, Germany
/ Felix Post
  • Department of Internal Medicine, Johannes Gutenberg-University, Mainz, Germany
/ Helmut Schinzel
  • Department of Internal Medicine, Johannes Gutenberg-University, Mainz, Germany
/ Rosemarie Schweigert
  • Institute of Clinical Chemistry and Laboratory Medicine, Johannes Gutenberg-University, Mainz, Germany
/ Caroline Schollmayer
  • Institute of Clinical Chemistry and Laboratory Medicine, Johannes Gutenberg-University, Mainz, Germany
/ Katrin Steinbach
  • Institute of Clinical Chemistry and Laboratory Medicine, Johannes Gutenberg-University, Mainz, Germany
/ Francesco Dati
  • IVD-Consulting, Marburg, Germany
/ Franz Noll
  • Diagenics International Corporation, Düsseldorf, Germany
/ Karl J. Lackner
  • Institute of Clinical Chemistry and Laboratory Medicine, Johannes Gutenberg-University, Mainz, Germany
Published Online: 2005-11-28 | DOI: https://doi.org/10.1515/CCLM.2005.231

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 24h later. GPBB plasma concentrations were elevated in 90.9% of patients 1h after onset of chest pain and increased to 100% at 4–5h. Within the first 6h, 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 (≥3h). In un-stable angina pectoris patients, a very high rate of elevated GPBB was observed (93.9% at 3h) 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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About the article

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,


Received: 2005-08-01

Accepted: 2005-09-27

Published Online: 2005-11-28

Published in Print: 2005-12-01



Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2005.231. Export Citation

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