Semi-quantitative estimation of serum myoglobin by a rapid latex agglutination method: an emergency screening test for acute myocardial infarction

The present study reports the evaluation of a new latex agglutination test for serum myoglobin (SMb). The time of agglutination of the latex particles coated with antibodies to myoglobin was measured in 172 serum specimens with known concentration of myoglobin quantitated by a radioimmunoassay (RIA), collected from myocardial infarction (MI) patients, subjects suffering from various diseases, and normal controls. Myoglobin levels in the samples were found to decrease exponentially with time of agglutination. Agglutination occurring within 1 min (result coded as + + + +) corresponded to 761 +/- 366 micrograms/l of myoglobin; between 1 and 2 min (+ + +), to 285 +/- 101 micrograms/l; between 2 and 3 min (+ +), to 85 +/- 47 micrograms/l; between 3 and 4 min (+), to 51 +/- 38 micrograms/l; and after more than 4 min (-), to 31 +/- 16 micrograms/l. Blood samples were serially drawn from 24 MI patients with short hospitalization delays; the rapid agglutination which was obtained in the specimens taken upon admission (20 results coded as + + + + and four as + + +) actually corresponded to markedly increased SMb levels. In contrast, serum creatine kinase (CK) activities were still less than 150 U/l in four patients (16.6%); CK-MB was less than 5 U/l in five cases (20.8%). Positive agglutinations for SMb were also obtained 4 and 8 h following admission in all subjects, confirming that the latex test is an early and very sensitive indicator for MI.(ABSTRACT TRUNCATED AT 250 WORDS)