Behavior of serum myoglobin during cardiac catheterization: Concise communication

We have studied 28 patients undergoing coronary angiography by the Judgkins technique to determine whether serum myoglobin (MG) might be useful as an indicator of myocardial injury during routine cardiac catheterization and coronary angiography. MG was measured immediately before and after the procedure, and 4 hr later. The study population failed to show a rise of MG outside the normal range in spite of angina, hypotension, or severe coronary disease. Four patients premedicated with intramuscular pentobarbital (positive control) showed a consistent rise, with a range 1.5-3 times normal (p < 0.001). We conclude that injury to myocardial or peripheral tissues occurring during coronary angiography does not raise myoglobin in venous blood above normal levels in the absence of myocardial infarction or preoperative intramuscular injection. Myoglobin, therefore, provides a useful test for the exclusion of myocardial infarction following coronary angiography.