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Article |

Prognostic Value of Enzymes in Myocardial Infarction

Eugene L. Coodley, MD
JAMA. 1973;225(6):597-600. doi:10.1001/jama.1973.03220330019004.
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In a series of 125 consecutive patients, enzyme determinations were performed at daily intervals for the first four days following acute myocardial infarction in order to assess the usefulness of enzymes in assessing prognosis. A direct relationship between amplitude of enzyme rise and early mortality was found; levels six times normal were associated with a hospital mortality of 56% (14 of 25). The incidence of arrhythmias was also correlated with enzyme activity, with 81.8% (102 of 125) of ventricular arrhythmias occurring in the group whose enzyme levels exceeded four times normal. In patients who developed congestive heart failure, the initial enzyme levels were four to five times normal. Cardiogenic shock was present in 10.4% (13 of 125) of patients and was not seen in any patient who did not have an enzyme rise at least five times normal.


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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