Surgery – Diagnostic testing
Patent
1997-11-07
2000-03-07
Nasser, Robert L.
Surgery
Diagnostic testing
600301, 128898, A61B 560
Patent
active
060333642
ABSTRACT:
The present invention is a method of diagnosing the presence of a persistent occlusion in a myocardial infarct patient undergoing thrombolytic therapy. The method comprises detecting a series of five variables from the patient and then generating the probability of the presence of a persistent occlusion from those variables. The first variable comprises a serum creatine kinase MB (CK-MB) level from a patient at the onset of thrombolytic therapy. The second variable comprises a second CK-MB level in the patient at a predetermined time after the onset of thrombolytic therapy. The third variable comprises the presence or absence of chest pain a predetermined time after the onset of thrombolytic therapy. The fourth variable comprises the serum myoglobin level in the patient at a predetermined time after the onset of thrombolytic therapy. In a preferred embodiment of the present invention, the second, third and fourth variables are detected within 30 minutes of each other and within about 1 to about 3 hours after the initial variable is detected. In an alternate embodiment a fifth variable reflecting the time from onset of chest pain to the beginning of thrombolytic therapy is included in the regression model.
REFERENCES:
patent: 5246001 (1993-09-01), Ohman et al.
patent: 5290678 (1994-03-01), Jackowski
R.H. Christenson et al; Combining Myoglobin and Clinical Variables for Assessing Coronary Reperfusion After Thrombolytic Therapy; Journal of the American College of Cardiology (Feb. 1995) Abstract 148A.
E.M. Ohman et al; Noninvasive detection of reperfusion after thrombolysis based on serum creatine kinase MB changes and clinical variables: American Heart J. 126, pp. 819-826 (1993).
P. Klootwijk et al; Noninvasive Assessment of Reperfusion and Reocclusion After Thrombolysis in Acute Myocardial Infarction; Am. J. Cardiol 72 pp. 75Q, 81-84Q (1993).
E.M. Ohman and R.H. Christenson; Noninvasive Assessment of Myocardial Reperfusion and REocclusion; Current Review of Interventional Cardiology 6, pp. 6.2-6.15 (E.J. Topol & P.W. Serruys, Eds., 1994).
T. Laperche et al; Patterns of Myoglobin and MM Creatin Kinase Isoforms Release Early After Intravenous Thrombolysis or Direct Percutaneous Transluminal Coronary Angioplasty for Acute Myocardial Infarction, and Implications for the Early Noninvasive Diagnosis of Reperfusion; Am. J. Cardiol 70 (1992) Abstract only.
J. Abe et al; Myocardial reperfusion can be predicted by myoglobin/creatinekinase ratio of a single blood sample obtained at the time of admission; Am. Heart J. 126 (1993) Abstract only.
J. Ishii et al; Early detection of successful coronary reperfusion based on serum myoglobin concentration: Comparison with serum creatine kinase isoenzyme MD activity Am. Heart J. 128 No. 4 (1994) Abstract only.
Califf Robert M.
Christenson Robert H.
O'Hanesian Mary Ann
Ohman E. Magnus
Sigmon Kristina N.
Duke University
Nasser Robert L.
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