Mercer’s Discovery 45 Years Ago of a Fast and Accurate Way to Detect Heart Attacks Still Making an Impact Today

  Don Mercer, WJU class of 1960
  Wednesday, January 17, 2018 10:54 AM
  WJU News, Alumni

Wheeling, WV

Don Mercer, Ph.D. and Ed Shahady, MD were classmates at Wheeling College, graduating in 1960. Each continued his education, with Mercer earning a master’s and doctorate in biochemistry from the University of Pittsburgh and Shahady earning a medical degree from West Virginia University.mercer-shahady-web.jpg

Their paths did not cross again until their 50th Wheeling College anniversary in 2010, where Dr. Shahady discovered that Dr. Mercer’s medical research in the early 1970s at Pittsburgh’s Montefiore Hospital, Department of Pathology made a significant impact on the recognition of heart attacks.

In the late 1960s, physicians were challenged when a patient presented with chest pain and the EKG was negative or questionable. Diagnosing myocardial infarctions (heart attacks) was difficult if the EKG was not positive. Blood tests at that time were not very specific, making it even more difficult for the physician's diagnosis. A more accurate blood test was needed.

At that time, Dr. Mercer was a biochemist in the clinical chemistry lab at Montefiore Hospital, teaching residents and medical technologists, evaluating new clinical tests developed by commercial companies, performing clinical medical research, and consulting with interns, residents and attending physicians. Dr. Mercer lunched with the Chief of Cardiology, Dr. Murray A. Varat, who often expressed his frustration about the lack of an accurate and fast blood test that could easily identify heart attacks especially when EKG's were questionable.

Dr. Mercer responded to the challenge and began successful experiments in his lab to find the perfect cardiac test. Following six months of work, he was the first to introduce a rapid blood enzyme test procedure (cardiac isoenzyme of creatine kinase, CK-MB) for early and precise identification of heart attacks. This was what physicians, Dr. Shahady included, were wishing for – a fast, accurate blood test measuring activity directly related to the occurrence of heart attacks.  

Prior to Mercer’s discovery, the use of other blood enzymes of cardiac origin were popular. These tests soon became questionable because of numerous reports of abnormal results owing to non-cardiac conditions, such as indigestion, strenuous exercise, electric shock treatment, surgery, multiple injections and accidental falls.

However, promising results were observed with the cardiac isoenzyme of creatine kinase, CK-MB. Clinical trials with the help of Dr. Varat showed CK-MB to be nearly 100 percent accurate

when patient tests were performed upon admission and every 24 hours for two consecutive days.  News of Mercer’s work spread quickly and the first commercial version was produced by Roche Diagnostics (Nutley, N.J.) about two years later.  A U.S. patent for isolation and measurement of CK-MB was granted to Dr. Mercer on Sept. 6, 1977.

Now, four decades later, Mercer’s work is considered to be one of the top 40 clinical chemistry papers of the 20th Century, alongside Nobel Prize works of Linus Pauling and Rosalyn Yalow, according to a 2006 book edited by Dr. Richard Rocco.

Shahady said of his classmate’s discovery, “My medical practice was significantly influenced by the availability of the CK-MB test. Before this test was available, other less reliable tests were performed. Both over and under diagnosis created increased costs, false diagnosis and inappropriate care. Don’s discovery saved lives and decreased the cost of medical care.”

Thanks to Mercer’s pioneering studies targeting CK-MB, other scientists have developed fully automated CK-MB tests, which are currently being performed world-wide and considered must do testing in patients with heart attack symptoms such as chest pain.

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