Document Detail

Prognostic significance of creatine kinase-MB elevation after percutaneous coronary intervention in patients with chronic renal dysfunction.
MedLine Citation:
PMID:  12075261     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Multiple studies have demonstrated a relationship between creatine kinase-MB (CK-MB) elevation after percutaneous coronary intervention (PCI) and increased late mortality within the general population. Because CK-MB is frequently elevated in renal disease even in the absence of myocardial injury, the clinical significance of CK-MB elevation after PCI in patients with renal insufficiency has been questioned. METHODS: We sought to examine the association between elevated CK-MB after PCI and late mortality in 190 consecutive patients with chronic renal insufficiency (serum creatinine > or =2.0 mg/dL) undergoing PCI at the Cleveland Clinic between January 1997 and March 2000. Of the total group, 20 patients undergoing PCI for acute myocardial infarction, cardiogenic shock, or both were excluded. Follow-up was 99.4% complete at a mean duration of 24.8 +/- 11.2 months (range 5-43 months). RESULTS: CK-MB elevation above the upper limit of normal after intervention was detected in 33 patients (19.4%). Baseline characteristics were not significantly different between the CK-MB elevation group and the normal CK-MB group. Late mortality, however, was significantly higher among patients with postprocedural CK-MB elevation (36.4% vs 17.5%, P =.017). Cox proportional hazard model revealed CK-MB elevation as an independent predictor of late mortality (hazard ratio 2.44, 95% CI 1.14-5.24, P =.02), in addition to New York Heart Association class (hazard ratio 1.35, 95% CI 1.05-1.73, P =.02). CONCLUSIONS: This analysis of patients with chronic renal insufficiency undergoing PCI suggests that postprocedural CK-MB elevation is an independent predictor of late mortality even in the presence of renal dysfunction.
Allen Jeremias; Abdulhay Albirini; Khaled M Ziada; Derek P Chew; Sorin J Brener; Eric J Topol; Stephen G Ellis
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  143     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-20     Completed Date:  2002-07-18     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1040-5     Citation Subset:  AIM; IM    
Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
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MeSH Terms
Analysis of Variance
Angioplasty, Transluminal, Percutaneous Coronary*
Biological Markers / blood
Coronary Disease / blood*,  complications,  mortality,  therapy*
Creatine Kinase / blood*
Creatine Kinase, MM Form
Fibrinolytic Agents / therapeutic use
Follow-Up Studies
Isoenzymes / blood*
Kidney Failure, Chronic / blood*,  complications,  mortality
Middle Aged
Platelet Glycoprotein GPIIb-IIIa Complex / therapeutic use
Proportional Hazards Models
Reg. No./Substance:
0/Biological Markers; 0/Fibrinolytic Agents; 0/Isoenzymes; 0/Platelet Glycoprotein GPIIb-IIIa Complex; EC Kinase; EC Kinase, MM Form

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