From the Guidelines
The LDH:CR ratio is not a recommended biomarker for diagnosing myocardial infarction, as stated in the study by 1, which suggests that lactate dehydrogenase should not be used to diagnose cardiac damage. Instead, the study recommends using cardiac troponin or the MB fraction of creatine kinase (CK-MB) as biomarkers for myocardial infarction. The LDH:CR ratio may be used in other clinical contexts, such as differentiating between exudative and transudative pleural effusions, but its use in diagnosing myocardial infarction is not supported by the evidence. Some key points to consider when evaluating biomarkers for myocardial infarction include:
- Cardiac troponin is the preferred biomarker due to its high sensitivity and specificity for myocardial damage, as noted in the study by 1.
- CK-MB is a suitable alternative if cardiac troponin assays are not available, as stated in the study by 1.
- The degree of biomarker elevation is related to clinical risk, and a classification for the extent of myocardial damage can be useful in guiding treatment approaches, as discussed in the study by 1.
- Other biomarkers, such as myoglobin and lactate dehydrogenase, are not recommended for diagnosing myocardial infarction due to their lower specificity and sensitivity, as noted in the study by 1.
From the Research
LDH CR Ratio
- The LDH CR ratio is not directly mentioned in the provided studies, however, the studies discuss the importance of lactate dehydrogenase (LDH) in various medical contexts 2, 3, 4, 5, 6.
- LDH is an enzyme that regulates the processing of glucose to lactic acid, and its levels are often increased in cancer patients, correlating with poor clinical outcome and resistance to therapy 2.
- The determination of LDH has become a standard supportive tool in diagnosing cancers or monitoring the effects of cancer treatment 2.
- In the context of myocardial infarction, the ratio of LDH-1 to total lactate dehydrogenase was found to offer no advantage in diagnosis 3.
- Elevated LDH levels have been associated with immune suppression in cancer, as well as increased risk of myocardial muscle injury in patients treated with anti-angiogenic drugs 4, 5.
- LDH levels have also been found to be inversely related to response to checkpoint inhibitors, with elevated levels indicating diminished antitumor immunity 6.