Other

Duke University

E Magnus Ohman

Robert H Christenson

Robert M Califf

Trevor D Thompson

Kristina N Sigmon

L Kristin Newby

Robin T Vollmer

Show-Hong Duh

Mary Ann O'Hanesian

A method for predicting the clinical outcome for a patient after the patient has received therapy for an acute coronary syndrome such as myocardial infarction comprises: (a) optionally, but preferably, detecting a first variable comprising a serum creatine kinase-MB release curve area in the patient after initiation of said therapy; (b) detecting a second variable comprising a serum creatine kinase-MB release curve maxima in the patient after initiation of said therapy; then (c) optionally, but preferably, detecting a third variable comprising the slope of the descending portion of the serum creatine kinase-MB release curve after initiation of said therapy (wherein a steep slope for said descending portion is a more favorable indicator of clinical outcome than a shallow slope); and (d) generating a prediction of clinical outcome for said patient from the variables collected above. The method is useful in conjunction with established therapies such as thrombolytic therapy, and is particularly useful as a surrogate end point in clinical trials of new potential therapies.

Methods for evaluating therapies and predicting clinical outcome related to coronary conditions

The present invention is a method of diagnosing the presence of a persistent occlusion in a myocardial infarct patient undergoing thrombolytic therapy. The method comprises detecting a series of five variables from the patient and then generating the probability of the presence of a persistent occlusion from those variables. The first variable comprises a serum creatine kinase MB (CK-MB) level from a patient at the onset of thrombolytic therapy. The second variable comprises a second CK-MB level in the patient at a predetermined time after the onset of thrombolytic therapy. The third variable comprises the presence or absence of chest pain a predetermined time after the onset of thrombolytic therapy. The fourth variable comprises the serum myoglobin level in the patient at a predetermined time after the onset of thrombolytic therapy. In a preferred embodiment of the present invention, the second, third and fourth variables are detected within 30 minutes of each other and within about 1 to about 3 hours after the initial variable is detected. In an alternate embodiment a fifth variable reflecting the time from onset of chest pain to the beginning of thrombolytic therapy is included in the regression model.

Method of assessing reperfusion after thrombolytic therapy

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Durham, NC, United States of America

E Magnus Ohman