Influence of moderately elevated levels of carboxyhemoglobin on the course of acute ischemic heart disease.

The purpose of this prospective study in 66 patients with acute ischemic heart disease was to analyze the possible effects of moderately elevated levels of carboxyhemoglobin (COHb) on the early course of this disease. Thirty-one patients presented with a level of COHb less than or equal to 2% and 35 with a level of greater than 2%. In the group with elevated COHb, more patients developed transmural infarction, but the difference was not significant (p = 0.123). Patients with transmural infarction had higher maximum CPK values (p less than 0.01), when COHb levels were greater than 2%. During the first 6 h after admission to hospital, these patients needed an antiarrhythmic treatment significantly more frequently (p = 0.003). Differences in rhythm disorders were still present at a time when nicotine, due to its short biological half-life, was already eliminated. We conclude that a moderately elevated level of COHb is not just a marker for recent smoking but may aggravate the course of acute ischemic heart disease.