Abnormal globulins in myocardial infarction: With special reference to a material coating erythrocytes and a cold-insoluble protein

Three groups of subjects were examined, twenty-five control subjects, ten patients with angina pectoris and twenty-eight patients with myocardial infarction. Of the patients studied during acute myocardial infarction and at a follow-up examination in the period after onvalescence, the results of the dextran celllatex fixation test demonstrated an abnormal protein coating the red cells in 77 per cent. This protein resembles “rheumatoid factor.” Its appearance was a transient phenomenon in the majority of patients but it persisted in five. A nonclottable cold-insoluble protein was found in small amounts (0 to 6 mg. per cent) in 70 to 90 per cent of patients in the three groups studied. Two patients showed a fourfold increase in this cryoprotein during acute myocardial infarction at the time thromboembolic complications developed. Filter paper electrophoresis showed transient alterations in nearly all serum protein fractions. The most prominent changes were an initial decrease in serum albumin concentration and an early rise in alpha 2 globulins. Fibrinogen was markedly increased in the acute phase. These changes are believed to reflect a nonspecific reaction to tissue injury. Alterations in the serum proteins could not be correlated with a positive reaction to the dextran cell-latex fixation test, a rise in the erythrocyte sedimentation rate or the severity of the illness. It would seem that the coating of the red cells with an abnormal macroglobulin and the appearance of cryoglobulins could have a pronounced influence upon the rheology of blood during myocardial infarction. This may be of theoretic interest and practical therapeutic importance.