Jump to ContentJump to Main Navigation
Show Summary Details
More options …

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.

12 Issues per year

IMPACT FACTOR 2016: 3.432

CiteScore 2016: 2.21

SCImago Journal Rank (SJR) 2016: 1.000
Source Normalized Impact per Paper (SNIP) 2016: 1.112

See all formats and pricing
More options …
Volume 43, Issue 12 (Dec 2005)


Glycogen phosphorylase BB in acute coronary syndromes

Dirk Peetz
  • Institute of Clinical Chemistry and Laboratory Medicine, Johannes Gutenberg-University, Mainz, Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Felix Post / Helmut Schinzel / Rosemarie Schweigert
  • Institute of Clinical Chemistry and Laboratory Medicine, Johannes Gutenberg-University, Mainz, Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Caroline Schollmayer
  • Institute of Clinical Chemistry and Laboratory Medicine, Johannes Gutenberg-University, Mainz, Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Katrin Steinbach
  • Institute of Clinical Chemistry and Laboratory Medicine, Johannes Gutenberg-University, Mainz, Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Francesco Dati / Franz Noll / Karl J. Lackner
  • Institute of Clinical Chemistry and Laboratory Medicine, Johannes Gutenberg-University, Mainz, Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2005-11-28 | DOI: https://doi.org/10.1515/CCLM.2005.231


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


  • 1.

    Alpert JS, Thygesen K, Antman E, Bassand JP. Myocardial infarction redefined – a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. J Am Coll Cardiol 2000; 36:959–69.CrossrefGoogle Scholar

  • 2.

    Christenson RH, Duh SH, Sanhai WR, Wu AH, Holtman V, Painter P, et al. Characteristics of an Albumin Cobalt Binding test for assessment of acute coronary syndrome patients: a multicenter study. Clin Chem 2001; 47:464–70.Google Scholar

  • 3.

    Alhadi HA, Fox KA. Do we need additional markers of myocyte necrosis: the potential value of heart fatty-acid-binding protein. QJM 2004; 97:187–98.CrossrefGoogle Scholar

  • 4.

    Rabitzsch G, Mair J, Lechleitner P, Noll F, Hofmann U, Krause EG, et al. Immunoenzymometric assay of human glycogen phosphorylase isoenzyme BB in diagnosis of ischemic myocardial injury. Clin Chem 1995; 41:966–78.Google Scholar

  • 5.

    Entman ML, Bornet EP, Van Winkle WB, Goldstein MA, Schwartz A. Association of glycogenolysis with cardiac sarcoplasmic reticulum: II. Effect of glycogen depletion, deoxycholate solubilization and cardiac ischemia: evidence for a phorphorylase kinase membrane complex. J Mol Cell Cardiol 1977; 9:515–28.CrossrefGoogle Scholar

  • 6.

    Newgard CB, Hwang PK, Fletterick RJ. The family of glycogen phosphorylases: structure and function. Crit Rev Biochem Mol Biol 1989; 24:69–99.CrossrefGoogle Scholar

  • 7.

    Kato K, Shimizu A, Kurobe N, Takashi M, Koshikawa T. Human brain-type glycogen phosphorylase: quantitative localization in human tissues determined with an immunoassay system. J Neurochem 1989; 52:1425–32.CrossrefGoogle Scholar

  • 8.

    Krause EG, Rabitzsch G, Noll F, Mair J, Puschendorf B. Glycogen phosphorylase isoenzyme BB in diagnosis of myocardial ischaemic injury and infarction. Mol Cell Biochem 1996; 160/161:289–95.Google Scholar

  • 9.

    Van de Werf F, Ardissino D, Betriu A, Cokkinos DV, Falk E, Fox KA, et al. Management of acute myocardial infarction in patients presenting with ST-segment elevation. The Task Force on the Management of Acute Myocardial Infarction of the European Society of Cardiology. Eur Heart J 2003; 24:28–66.CrossrefGoogle Scholar

  • 10.

    Bertrand ME, Simoons ML, Fox KA, Wallentin LC, Hamm CW, McFadden E, et al. Management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2002; 23:1809–40.CrossrefWeb of ScienceGoogle Scholar

  • 11.

    Panteghini M. Acute coronary syndrome: biochemical strategies in the troponin era. Chest 2002; 122:1428–35.CrossrefGoogle Scholar

  • 12.

    Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, et al. ACC/AHA 2002 guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial in-farction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Unstable Angina). http://www.acc.org/clinical/guidelines/unstable/unstable.pdf.Google Scholar

  • 13.

    Jesse RL. Rationale for the early clinical application of markers of ischemia in patients with suspected acute coronary syndromes. In: Wu AH, editor. Cardiac markers, 2nd ed. Totowa, NJ: Humana Press, 2003:245–57.Google Scholar

  • 14.

    Morrow DA, de Lemos JA, Sabatine MS, Antman EM. The search for a biomarker of cardiac ischemia. Clin Chem 2003; 49:537–9.CrossrefGoogle Scholar

  • 15.

    Wu AH, Morris DL, Fletcher DR, Apple FS, Christenson RH, Painter PC. Analysis of the Albumin Cobalt Binding (ACB) test as an adjunct to cardiac troponin I for the early detection of acute myocardial infarction. Cardiovasc Toxicol 2001; 1:147–51.Google Scholar

  • 16.

    Peeters RA, in't Groen MA, Veerkamp JH. The fatty acid-binding protein from human skeletal muscle. Arch Biochem Biophys 1989; 274:556–63.Google Scholar

  • 17.

    Sorichter S, Mair J, Koller A, Pelsers MM, Puschendorf B, Glatz JF. Early assessment of exercise induced skeletal muscle injury using plasma fatty acid binding protein. Br J Sports Med 1998; 32:121–4.CrossrefGoogle Scholar

  • 18.

    Apple FS, Wu AH, Mair J, Ravkilde J, Panteghini M, Tate J, et al. Future biomarkers for detection of ischemia and risk stratification in acute coronary syndrome. Clin Chem 2005; 51:810–24.CrossrefGoogle Scholar

  • 19.

    Rabitzsch G, Mair J, Lechleitner P, Noll F, Hofmann V, Krause EG, et al. Isoenzyme BB of glycogen phosphorylase b and myocardial infarction. Lancet 1993; 341:1032–3.Google Scholar

  • 20.

    Setsuta K, Seino Y, Takahashi N, Ogawa T, Sasaki K, Harada A, et al. Clinical significance of elevated levels of cardiac troponin T in patients with chronic heart failure. Am J Cardiol 1999; 84:608–11.CrossrefGoogle Scholar

  • 21.

    Peetz D, Schutt S, Sucke B, Faldum A, Wandel E, Hafner G, et al. Prognostic value of troponin T, troponin I, and CK-MB mass in patients with chronic renal failure. Med Klin (Munich) 2003; 98:188–92.CrossrefGoogle Scholar

  • 22.

    Byrick RJ. Fat embolism and postoperative coagulopathy. Can J Anaesth 2001; 48:618–21.CrossrefGoogle Scholar

  • 23.

    Backlund M, Lepantalo M, Toivonen L, Tuominen M, Tarkkil P, Pere P, et al. Factors associated with post-operative myocardial ischaemia in elderly patients undergoing major non-cardiac surgery. Eur J Anaesthesiol 1999; 16:826–33.Google Scholar

  • 24.

    Richter F, Bohme HJ, Hofmann E. Changes of glycogen phosphorylase isozyme pattern, in rat tissues during pre- and postnatal development. Biomed Biochim Acta 1988; 47:743–52.Google Scholar

  • 25.

    Mair J. Glycogen phosphorylase isoenzyme BB to diagnose ischaemic myocardial damage. Clin Chim Acta 1998; 272:79–86.Google Scholar

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

©2005 by Walter de Gruyter Berlin New York. Copyright Clearance Center

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Neelima Singh, Vedika Rathore, Roshan Kumar Mahat, and Puneet Rastogi
Indian Journal of Clinical Biochemistry, 2017
Fergus P. McCarthy, Aisling Doyle, Ali S. Khashan, and Louise C. Kenny
Reproductive Sciences, 2016, Volume 23, Number 6, Page 738
Giuseppina Novo, Christian Cadeddu, Vincenzo Sucato, Pasquale Pagliaro, Silvio Romano, Carlo G. Tocchetti, Concetta Zito, Luca Longobardo, Savina Nodari, and Maria Penco
Journal of Cardiovascular Medicine, 2016, Volume 17, Page e27
Matthias K. Freynhofer, Miloš Tajsić, Johann Wojta, and Kurt Huber
Wiener Medizinische Wochenschrift, 2012, Volume 162, Number 21-22, Page 489
Milan Dobric, Miodrag Ostojic, Vojislav Giga, Ana Djordjevic-Dikic, Jelena Stepanovic, Nebojsa Radovanovic, and Branko Beleslin
Clinica Chimica Acta, 2015, Volume 438, Page 107
Eduardo Fernández, Carlos García, Rafael de la Espriella, Carmelo R. Dueñas, and Fernando Manzur
Revista Colombiana de Cardiología, 2012, Volume 19, Number 6, Page 300
Jun LIU, Xue WANG, Yu-Peng CHEN, Li-Fei MAO, Jing SHANG, Hong-Bin SUN, and Lu-Yong ZHANG
Chinese Journal of Natural Medicines, 2014, Volume 12, Number 4, Page 259
Jan M. Horacek, Martina Vasatova, Radek Pudil, Milos Tichy, Pavel Zak, Martin Jakl, Ladislav Jebavy, and Jaroslav Maly
Biomedical Papers, 2014
Ram P. Tiwari, Anubhav Jain, Zakir Khan, Veena Kohli, R. N. Bharmal, S. Kartikeyan, and Prakash S. Bisen
Molecular Diagnosis & Therapy, 2012, Volume 16, Number 6, Page 371
David Stejskal, Borek Lacnak, Libor Jedelsky, Leona Stepanova, Jitka Proskova, Pavlina Solichova, Lenka Kadalova, Marie Janosova, Petra Seitlova, Michal Karpisek, and Ludek Sprongl
Biomedical Papers, 2007, Volume 151, Number 2, Page 247
Lars Lillpopp, Stergios Tzikas, Francisco Ojeda, Tanja Zeller, Stephan Baldus, Christoph Bickel, Christoph R. Sinning, Philipp S. Wild, Sabine Genth-Zotz, Ascan Warnholtz, Karl J. Lackner, Thomas Münzel, Stefan Blankenberg, and Till Keller
The American Journal of Cardiology, 2012, Volume 110, Number 9, Page 1225
Christophe Meune, Karim Wahbi, Simon Weber, Stéphane Zuily, Luc Cynober, and Camille Chenevier-Gobeaux
Clinical Biochemistry, 2011, Volume 44, Number 16, Page 1343
Olaf Schulz, Claudia Paul-Walter, Matthias Lehmann, Klaus Abraham, Gunnar Berghöfer, Ingolf Schimke, and Allan S. Jaffe
The American Journal of Cardiology, 2007, Volume 100, Number 5, Page 764
Giuseppe Lippi, Federico Schena, Martina Montagnana, Gian Luca Salvagno, and Gian Cesare Guidi
Clinical Chemistry and Laboratory Medicine, 2008, Volume 46, Number 9
Radek Pudil, Martina Vašatová, Juraj Lenčo, Miloš Tichý, Vít Řeháček, Alena Fučíková, Jan M. Horáček, Jan Vojáček, Miloslav Pleskot, Jiří Stulík, and Vladimír Palička
Clinical Chemistry and Laboratory Medicine, 2010, Volume 48, Number 8
Jan M. Horacek, Milos Tichy, Radek Pudil, Ladislav Jebavy, Pavel Zak, Martina Ulrychova, Jaroslava Vavrova, Jaroslav Maly, and Vladimir Palicka
Clinical Chemistry and Laboratory Medicine, 2008, Volume 46, Number 1
Vikas Singh, Pedro Martinezclark, Mario Pascual, Eric Scot Shaw, and William W. OʼNeill
Coronary Artery Disease, 2010, Volume 21, Number 4, Page 244
Heide Schmid, Brigitte Pfeiffer-Guglielmi, Benedikt Dolderer, Ulrike Thiess, Stephan Verleysdonk, and Bernd Hamprecht
Neurochemical Research, 2009, Volume 34, Number 3, Page 581
Radek Pudil, Petr Pařízek, Miloš Tichý, Luděk Haman, Lucie Horáková, Martina Ulrychová, Jan Vojáček, and Vladimír Palička
Clinical Chemistry and Laboratory Medicine, 2008, Volume 46, Number 12
Christina Buse, Frank Altmann, Barbara Amann, Stefanie M. Hauck, Cordula Poulsen Nautrup, Marius Ueffing, Manfred Stangassinger, and Cornelia A. Deeg
ELECTROPHORESIS, 2008, Volume 29, Number 6, Page 1325

Comments (0)

Please log in or register to comment.
Log in