Time-related changes in the diagnostic utility of total lactate dehydrogenase, lactate dehydrogenase isoenzyme-1, and two lactate dehydrogenase isoenzyme-1 ratios in serum after myocardial infarction

1990 ◽  
Vol 36 (7) ◽  
pp. 1317-1322 ◽  
Author(s):  
L V Galbraith ◽  
F Y Leung ◽  
G Jablonsky ◽  
A R Henderson
Keyword(s):  
Myocardial Infarction ◽  
Lactate Dehydrogenase ◽  
Likelihood Ratio ◽  
Roc Curve ◽  
Operating Characteristic ◽  
Negative Likelihood Ratio ◽  
Diagnostic Utility ◽  
Time Intervals ◽  
Dehydrogenase Isoenzyme ◽  
Cardiac Care Unit

Abstract Using receiver-operating characteristic (ROC) curve and likelihood ratio analysis, we examined the diagnostic utility of total lactate dehydrogenase (LD; EC 1.1.1.27) activity (I). LD isoenzyme-1 activity (II), and the LD-1 percentage of total LD activity (III), LD-1 LD-2 (IV), and LD-1/LD-4 (V) in 347 persons admitted to the Cardiac Care Unit (of whom 173 were subsequently proven to have had myocardial infarction). Blood was sampled from these subjects at about 6-h intervals for up to 96 h from the onset of chest pain. Defining an "effective" test as one having an area under the ROC curve of greater than or equal to 0.9, we determined the ranked utility (greatest to least) of these tests as V = IV greater than III greater than II greater than I. Tests III, IV, and V had by this criterion, diagnostic effectiveness equivalent to measurements of creatine kinase-2 in serum but in samples obtained at later time intervals. The decision thresholds for both high (constant) test sensitivity and specificity varied with time, to differing extents, over the entire 96-h period, a finding with important diagnostic implications. We document positive and negative likelihood ratio values for each of these tests throughout the entire period of study.

scholarly journals The value of glycosylated hemoglobin in the diagnosis of diabetic retinopathy: a systematic review and Meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Zhang ◽  
Bingjie Zhang ◽  
Zhulin Zhou ◽  
Yutong Guo ◽  
Dan Wang
Keyword(s):  
Diabetic Retinopathy ◽  
Likelihood Ratio ◽  
Roc Curve ◽  
Meta Analysis ◽  
Glycosylated Hemoglobin ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Clinical Value

AbstractObjectiveGlycosylated hemoglobin (HbA1c) has obvious clinical value in the diagnosis of diabetes, but the conclusions on the diagnostic value of diabetic retinopathy (DR) are not consistent. This study aims to comprehensively evaluate the accuracy of glycosylated hemoglobin in the diagnosis of diabetic retinopathy through the meta-analysis of diagnostic tests.MethodsCochrane Library, Embase, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), China Wanfang Database, Chinese Biomedical Literature Database (CBM) were searched until November, 2020. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of the included studies. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR) and areas under the receiver operating characteristic (ROC) curve were calculated by Stata 15.0 software.ResultsAfter screening, 18 high-quality papers were included. The results of meta-analysis showed that the combined DOR = 18.19 (95% CI: 10.99–30.11), the sensitivity= 0.81 (95% CI): 0.75 ~ 0.87), specificity = 0.81 (95%CI: 0.72 ~ 0.87), +LR = 4.2 (95%CI: 2.95 ~ 6.00), −LR = 0.23 (95%CI: 0.17 ~ 0.31), and the area under the Summary ROC curve was 0.88 (95%CI:  0.85 ~ 0.90).ConclusionThe overall accuracy of HbA1cC forin diagnosing diabetic retinopathy is good. As it is more stable than blood sugar and is not affected by meals, it may be a suitable indicator for diabetic retinopathy.

Pleuraerguss: Vereinfachte Kriterien zur Unterscheidung zwischen Exsudat und Transsudat

2019 ◽  
Vol 7 (6) ◽  
pp. 331-332
Author(s):  
Franz Stanzel
Keyword(s):  
Lactate Dehydrogenase ◽  
Diagnostic Accuracy ◽  
Pleural Fluid ◽  
Likelihood Ratio ◽  
Validation Cohort ◽  
Characteristic Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Serum Lactate Dehydrogenase ◽  
Pleural Effusions

Background: An important part of the investigation of pleural effusion is the identification of markers that help separate exudate from transudate. Objectives: The purposes of this study were to compare the accuracy of published and new sets of criteria to distinguish between exudative and transudative pleural effusions, and to determine whether serum biochemical analysis is necessary. Methods: An externally validated cohort study was performed. Pleural effusions were determined to be transudative or exudative on the basis of an assessment of the medical record by two clinicians blinded to biochemical results. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and area under the receiver operating characteristic curve were determined for each proposed combination of criteria. Results: Pleural fluid analysis was available for 311 thoracenteses in the main cohort and for 112 thoracenteses in the validation cohort. The best sensitivity (97% [95% CI 94-99]) and negative likelihood ratio (0.04 [95% CI 0.02-0.08]) for identifying exudative effusions were observed with criteria combining pleural fluid lactate dehydrogenase greater than 0.6 the upper limit of normal serum lactate dehydrogenase and pleural fluid cholesterol greater than 1.04 mmol/L (40 mg/dL). The overall diagnostic accuracy was similar to Light's criteria. Findings were similar in the validation cohort. Conclusions: Our proposed criteria using simultaneously pleural fluid lactate dehydrogenase and pleural fluid cholesterol can identify an exudate with a sensitivity and an overall diagnostic accuracy similar to Light's criteria. It avoids simultaneous blood sampling, thus reducing patient discomfort and potential costs.

Lactate dehydrogenase isoenzyme-1 in serum for detection of peri-operative myocardial infarction after cardiac surgery.

1988 ◽  
Vol 34 (12) ◽  
pp. 2469-2474 ◽  
Author(s):  
Z Rotenberg ◽  
J E Squires ◽  
M T Johnston ◽  
J Hoyt ◽  
R S Gibson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Surgery ◽  
Lactate Dehydrogenase ◽  
Valve Replacement ◽  
Artery Bypass ◽  
Reference Intervals ◽  
Serum Lactate ◽  
Serum Lactate Dehydrogenase ◽  
Present Measurement ◽  
Dehydrogenase Isoenzyme

Abstract We prospectively studied changes in serum lactate dehydrogenase isoenzyme-1 (LD-1, EC 1.1.1.27) in 99 consecutive patients after either coronary artery bypass grafting (CABG, n = 61), isolated cardiac-valve replacement (n = 24), or the two procedures combined (n = 14); 86 of these had no clinical evidence of peri-operative myocardial infarction (MI). Blood was sampled immediately after surgery and at 6-h intervals for up to 42 h thereafter. LD-1 was isolated by using the LD M-subunit antiserum. Samples from the non-MI patients were used to establish the reference intervals for LD-1. By 24 h after surgery, mean serum LD-1 values were higher (P less than 0.001) in non-MI patients who underwent isolated valve replacement (222 +/- 74 U/L) or combined CABG and valve replacement (266 +/- 58 U/L) than in 50 non-MI patients who underwent CABG alone (134 +/- 42 U/L). Separate reference intervals were determined for CABG and other patients at each sampling time. By 24 h after operation, LD-1 exceeded these reference intervals in the 10 CABG and two combined-procedure patients in whom other evidence of MI was present. Measurement of LD-1 24 to 42 h after cardiac surgery appears to be a useful test for the diagnosis of perioperative MI.

Clinical evaluation of immunochemical assay of lactate dehydrogenase isoenzyme 1 in early detection of acute myocardial infarction.

1982 ◽  
Vol 28 (10) ◽  
pp. 2152-2154 ◽  
Author(s):  
T Y Wang ◽  
J H Godfrey ◽  
L G Graham ◽  
M N Haddad ◽  
T C Hamilton
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Lactate Dehydrogenase ◽  
Myocardial Ischemia ◽  
Clinical Presentation ◽  
Myocardial Infarct ◽  
Acute Myocardial Infarct ◽  
Group Iii ◽  
Dehydrogenase Isoenzyme ◽  
Group I

Abstract We immunochemically measured lactate dehydrogenase isoenzyme 1 (LD-1), calculated LD-1/LD ratios (% LD-1) for 122 specimens from 60 patients, and compared the results with those for the conventional cardiac profile and other findings such as clinical presentation and electrocardiogram. Results for LD-1 and % LD-1 could be classified into three groups: group I, with LD-1 less than 64 U/L; group II, with LD-1 greater than 64 U/L and % LD-1 between 17 and 37%; and group III, with LD-1 greater than 64 U/L and 5 LD-1 greater than 38%. These three groups correlated closely and consistently with three patients of cardiac profile, i.e., those of no acute myocardial infarct, myocardial ischemia, and acute myocardial infarct, respectively.

Method variation in lactate dehydrogenase isoenzyme determination.

1981 ◽  
Vol 27 (4) ◽  
pp. 624-625 ◽  
Author(s):  
N M Papadopoulos
Keyword(s):  
Myocardial Infarction ◽  
Lactate Dehydrogenase ◽  
Test Results ◽  
Dehydrogenase Isoenzyme ◽  
Lactate Dehydrogenase Isoenzymes

Abstract Differences between methods for determining lactate dehydrogenase isoenzymes are illustrated, which can account for discrepant results. They should be taken into consideration in the interpretation of test results for the diagnosis of myocardial infarction.

Validation of the ASAS criteria and definition of a positive MRI of the sacroiliac joint in an inception cohort of axial spondyloarthritis followed up for 8 years

2011 ◽  
Vol 71 (1) ◽  
pp. 56-60 ◽  
Author(s):  
Sibel Z Aydin ◽  
W P Maksymowych ◽  
A N Bennett ◽  
D McGonagle ◽  
P Emery ◽  
...  
Keyword(s):  
Likelihood Ratio ◽  
Global Assessment ◽  
Human Leucocyte Antigen ◽  
Axial Spondyloarthritis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Utility ◽  
Asas Criteria ◽  
Definition Of ◽  
Sensitivity Specificity

BackgroundThe new Assessment of SpondyloArthritis international Society (ASAS) criteria classify axial spondyloarthritis (SpA) into human leucocyte antigen-B27 and/or imaging-based arms. To aid implementation, ASAS has proposed a definition of a positive MRI for active sacroiliitis.ObjectiveThe authors aimed to test the diagnostic and predictive value of the ASAS criteria and definition of a ‘positive’ MRI.MethodsBaseline MRI scans on 29 patients with early inflammatory back pain and 18 controls were read independently by four experienced rheumatologists. Both arms of the criteria were tested against a ‘gold standard’ of physician diagnosis of SpA. MRI abnormalities were assessed according to a global assessment of MRI and the ASAS definition. Sensitivity, specificity and likelihood ratios for individual and concordant reader data were calculated for axial SpA diagnosis at baseline and the development of radiographic sacroiliitis, fulfilling the modified New York criteria at 8 years.ResultsAll patients were classified as having axial SpA, with more patients fulfilling the imaging arm (83%, n=24/29) than the human leucocyte antigen B27 arm (62%, n=18/29). Concordant reader data showed that the baseline MRI had high diagnostic utility for SpA according to global assessment (sensitivity/specificity: 66%/94%, LR+ (positive likelihood ratio) 11.8, LR− (negative likelihood ratio) 0.4) and ASAS definition (sensitivity/specificity: 79%/89%, LR+ 7.1, LR− 0.2). Likewise, a positive baseline MRI had 100% sensitivity for subsequent radiographic sacroiliitis by either assessment, although specificity was lower (56% for global assessment and 33% for ASAS definition).ConclusionBoth arms of the ASAS criteria have good diagnostic utility in early SpA, although they are of limited value for the prediction of radiographic progression. This may be due to the definition of a positive MRI for sacroiliitis that lacks specificity at baseline.

scholarly journals Diagnostic utility of measuring lactate dehydrogenase levels and its isoenzyme activities for the evaluation of malignancy in feline pleural effusion and ascitic fluid

2021 ◽  
Author(s):  
Eiji Naito ◽  
Roka Shimada ◽  
Masashi YUKI
Keyword(s):  
Lactate Dehydrogenase ◽  
Pleural Effusion ◽  
Infectious Diseases ◽  
Ascitic Fluid ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Diagnostic Utility ◽  
Malignant Effusion ◽  
Ldh Isoenzymes ◽  
Auc Value

Abstract Lactate dehydrogenase (LDH) isoenzymes may be useful in the differential diagnosis of pleural effusion (PE) and ascitic fluid (AF) etiologies in cats since tissue damage induces their release, thereby changing the pattern of their activity. The present study aimed to determine the diagnostic utility of measuring LDH levels and its isoenzyme activities in PE or AF in cats with malignancy. We measured LDH levels and its isoenzyme activities in serum, PE, and AF in 29 cats and compared the results between malignant, infectious diseases, and non-malignant, non-infectious diseases. Receiver operating characteristic (ROC) analysis was performed to assess the accuracy of the tests in diagnosing feline malignancy. In PE or AF, significant differences were found in LDH levels and LDH isoenzymes activities among the three groups. The combination of LDH level and LDH-1 activity in PE or AF had the highest area under the ROC (AUC) value of 0.874 for discriminating malignant effusion from non-malignant effusion. The sensitivity and specificity of using the combination of LDH level (cutoff: <2,269 U/L) and LDH-1 activity (cutoff: <4.8%) in PE or AF for predicting malignancy with the highest AUC value were 94.4% and 72.7%, respectively. Our results suggest that the combination of LDH level and LDH-1 activity in PE or AF can potentially diagnose for malignancy. Considering that LDH isoenzymes can be measured inexpensively and easily, LDH tests can be readily accommodated in veterinary clinical practice.

Sign in / Sign up

Export Citation Format

Share Document