Relation of cardiac complications to SGOT level in acute myocardial infarction

Abstract

The incidence of each of the commoner cardiac complications of acute myocardial infarction was correlated with the serum aspartic aminotransferase (SGOT) level in cases treated in a coronary care unit. There was a highly significant linear correlation between SGOT level and the incidence of supraventricular and ventricular arrhythmias, complete heart block, bundle-branch block, myocardial insufficiency, and secondary cardiac arrest. Increasing SGOT levels were accompanied by an increasing incidence of each of these complications except sinus bradycardia, whose incidence decreased. The distribution of primary cardiac arrest was independent of the SGOT level. These results were interpreted as showing that the cardiac complications occur with a frequency which is in direct proportion to the size of the infarct. Other workers have shown that the height to which the SGOT rises is proportional to the volume of infarcted myocardium. It was further suggested that, in cases treated in a coronary care unit, these complications are only indirectly related to the mortality rate, their presence merely reflecting the extent of infarction. Each of the complications whose incidence increased with the SGOT level was shown in a previous paper to be associated with an increase in the mortality rate, whereas sinus bradycardia was associated with a decrease. Primary cardiac arrest was associated with no change. The overall mortality rate was previously shown to have a highly significant linear correlation with the SGOT level. It was emphasized, however, that the present study does not exclude the possibility that some cardiac complications may exert an influence on the mortality rate over and above that which is indirect and merely a reflection of the extent of infarction present.