Document Detail

Usefulness of lactate dehydrogenase and lactate dehydrogenase isoenzymes for diagnosis of acute myocardial infarction.
MedLine Citation:
PMID:  3354438     Owner:  NLM     Status:  MEDLINE    
The usefulness of lactate dehydrogenase (LD) and LD isoenzymes in the diagnosis of acute myocardial infarction (AMI) is controversial. The present study reviewed 507 consecutive patients in whom creatine kinase, creatine kinase isoenzymes, LD and LD isoenzymes were ordered over a 1-month period. Of these, 249 had an insufficient number of serial enzyme determinations to establish a laboratory diagnosis of AMI. After excluding an additional 11 patients for other reasons, 247 patients remained for analysis. Of these, only 2 (0.8%) had myocardial infarction by standard clinical criteria with normal creatine kinase and creatine kinase-MB but elevated LD and abnormal LD isoenzymes. Seven patients (7 of 247, 2.8%) had false-positive LD isoenzymes. Thus, the routine use of LD and LD isoenzymes was of no use in most patients (96%) and led to the incorrect diagnosis of AMI more than 3 times as often as it helped with a correct diagnosis. Total 1-month charges for all the LD and LD isoenzymes obtained equalled +42,450. Therefore, it appears that LD and LD isoenzymes are not routinely useful in the diagnosis of AMI and may result in considerable unnecessary expense. It is suggested that LD and LD isoenzymes be ordered only under suspicion of late presentation (greater than 48 hours) of AMI.
G J Reis; H W Kaufman; G L Horowitz; R C Pasternak
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  61     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1988 Apr 
Date Detail:
Created Date:  1988-04-22     Completed Date:  1988-04-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  754-8     Citation Subset:  AIM; IM    
Charles A. Dana Research Institute, Boston, Massachusetts.
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MeSH Terms
Creatine Kinase / blood
False Positive Reactions
L-Lactate Dehydrogenase / blood*
Myocardial Infarction / diagnosis*
Reg. No./Substance:
0/Isoenzymes; EC Dehydrogenase; EC Kinase

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