Document Detail


Elevated CK-MB values after routine angioplasty predicts worse long-term prognosis in low-risk patients.
MedLine Citation:
PMID:  19670037     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The long-term prognostic value (>5 years) of elevated cardiac biomarkers after elective coronary angioplasty is yet not clear. Most previous studies have included high risk, unstable patients. The aim of this study was to determine the prognostic value of CK-MB mass > or = three times the reference after elective angioplasty in low-risk patients with stable angina. METHODS: A total of 278 consecutive patients were included in the final analysis. Patients with elevated CK-MB values at baseline, and those suffering an acute coronary syndrome <1 month before the time of inclusion, were excluded. Blood samples were drawn just before and 1-3 hours, 4-8 hours after the procedure and the next morning. Nineteen patients (6.8%) had peak CK-MB mass values > or =15 microg/L (three times the reference), and 259 patients had values <15 microg/L (defined as controls). No patient developed new Q-waves on ECG. The median follow-up time was 80.5 months. RESULTS: None of the patients died during the procedure or within the first 30 days after angioplasty, confirming a low risk cohort. All cause mortality, readmission for acute coronary syndromes and target lesion revascularisation (TLR) were more frequent in patients with high CK-MB, 42.1% vs. 22.8%, p=0.034 (log rank). In a multivariate logistic regression analysis, high CK-MB and former angioplasty were the only variables independently related to a reduced event-free survival. CONCLUSIONS: CK-MB mass values > or = three times the reference after elective angioplasty predicts reduced long-term event-free survival.
Authors:
Kjell Vikenes; Tor Melberg; Mikael Farstad; Jan Erik Nordrehaug
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian cardiovascular journal : SCJ     Volume:  44     ISSN:  1651-2006     ISO Abbreviation:  Scand. Cardiovasc. J.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-19     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708377     Medline TA:  Scand Cardiovasc J     Country:  England    
Other Details:
Languages:  eng     Pagination:  69-75     Citation Subset:  IM    
Affiliation:
Department of Heart Disease, Haukeland University Hospital, Bergen, Norway. vike@haukeland.no
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angina Pectoris / enzymology,  etiology,  therapy
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*,  instrumentation,  mortality
Biological Markers / blood
Chi-Square Distribution
Coronary Stenosis / complications,  enzymology,  mortality,  therapy*
Creatine Kinase, MB Form / blood*
Disease-Free Survival
Female
Humans
Kaplan-Meiers Estimate
Linear Models
Logistic Models
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Risk Assessment
Risk Factors
Stents
Time Factors
Treatment Outcome
Up-Regulation
Chemical
Reg. No./Substance:
0/Biological Markers; EC 2.7.3.2/Creatine Kinase, MB Form

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