Incidence, predictors, and significance of abnormal cardiac enzyme rise in patients treated with bypass surgery in...

Area of Science:

• Cardiology
• Cardiac Surgery
• Biomarkers

Background:

• Limited data exist on creatine kinase-MB (CK-MB) elevation after coronary artery bypass grafting (CABG).
• Previous studies suggest CK-MB elevation post-percutaneous coronary intervention (PCI) correlates with adverse outcomes.

Purpose of the Study:

• To investigate the incidence, predictors, and prognostic significance of CK-MB elevation following multivessel CABG.

Main Methods:

• Analysis of 496 patients undergoing multivessel CABG in the Arterial Revascularization Therapies Study (ARTS).
• Prospective measurement of CK-MB at 6, 12, and 18 hours post-procedure.
• 30-day and 1-year clinical follow-up.

Main Results:

• Abnormal CK-MB elevation occurred in 61.9% of patients.
• Increased CK-MB levels were associated with a higher risk of death and repeat myocardial infarction within 30 days (P=0.001).
• CK-MB elevation independently predicted late adverse outcomes (P=0.009, OR=0.64).

Conclusions:

• Elevated CK-MB concentrations post-multivessel CABG are frequent.
• These elevations are associated with significantly increased risks of repeat myocardial infarction and death beyond the perioperative period.
• CK-MB elevations should not be dismissed as inconsequential in CABG patients.