Early appearance of 2,3-butanediol in acute myocardial infarction. A new marker for ischaemia?

In 28 patients with acute myocardial infarction, the release pattern of 2,3-butanediol (BD), a product of intermediary metabolism, and creatine kinase activity (CK) in blood were compared. Whereas CK at entry was low in all patients, the BD level was elevated in 18 (64%). However, BD returned to normal levels during the next 24 h whereas CK increased. The BD level at entry did not allow differentiation between patients with transmural or non-transmural infarction; it was independent of clinical findings and biochemical parameters. We suggest that, in patients with acute myocardial infarction, elevated levels of BD originates from myocardial metabolism. Whether it reflects ongoing ischaemia or reperfusion of the infarcted area remains unresolved.