Comparison of the Serum Glutamic Oxaloacetic Transaminase, Serum Glutamic Pyruvic Transaminase and Lactic Dehydrogenase Activity Following Acute Myocardial Infarction

Abstract

1. The activities of serum glutamic oxaloacetic transaminase (SGO-T), serum glutamic pyruvic transaminase (SGP-T) and serum lactic dehydrogenase (SLD) were measured daily for six to 11 days in 84 patients, 34 with transmural acute myocardial infarction, 31 with myocardial ischemia of varying degree and 24 with a variety of cardiovascular diseases. 2. The SGO-T was found elevated in 29 of the 31 patients with unequivocal myocardial infarction; the SGP-T was elevated in 27 and the SLD in 26. 3. The average peak activity for SGO-T developed within 24 hours and was three to four times that of the upper limit of normal. The SGP-T peak noted at approximately the same time was twice normal, while the SLD peak which occurred approximately 24 hours later than the SGO-T and SGP-T was two and one-half times the upper limits of normal. 4. The SLD activity remained elevated for two to five days longer than did the SGO-T and SGP-T. 5. A secondary rise to borderline abnormal values was noted in the average tracing for SGP-T activity on the ninth to 11th day. 6. A rough correlation was found between the severity of the clinical condition and the maximum levels of all three enzymes. 7. In 31 patients with coronary insufficiency with or without myocardial infarction the agreement between the clinical and enzyme diagnosis was close. Enzymes were found elevated in 11 of the 12 patients with the presumptive diagnosis of myocardial infarction. Of the 18 assumed to have myocardial ischemia one or more of the three enzymes was found elevated in four. 8. In a control group with a variety of cardiovascular disease minimal elevations of the SGP-T and SLD were found in seven while the SGO-T was found slightly elevated in five. 9. The above findings coroborate the experimental observations previously reported from our laboratory. The clinical value of serial determinations of SGO-T, SLD and SGP-T is limited to the cases that come to the attention of the physician after the fifth day of symptoms.