Non-invasive assessment of coronary artery patency after thrombolysis using serum myoglobin measurements.

Timely identification of patients with patent infarct-related artery (IRA) may permit rapid triaging to avoid unnecessary repeat thrombolysis or rescue percutaneous coronary intervention (PCI). Various biomarkers have been proposed to assess IRA patency status. Our group found that the ratio of serum myoglobin levels obtainned before and 60-min after initiation of thrombolytic therapy may provide an early indication of the IRA patency status. A 60-min myoglobin ratio of >or= 4.0 indicated the probability of a patent IRA of 90%, suggesting that follow-up diagnostic modalities such as emergency coronary angiography to determine the IRA status may be unnecessary when these dynamics of myoglobin are observed.