Association between CK-MB elevation after percutaneous or surgical revascularization and three-year mortality

Area of Science:

• Cardiology
• Biochemistry
• Clinical Medicine

Background:

• Long-term impact of creatine kinase-MB (CK-MB) elevation post-coronary artery bypass grafting (CABG) is less understood than after percutaneous coronary intervention (PCI).
• CK-MB is a biomarker released into the bloodstream following myocardial injury.

Purpose of the Study:

• To evaluate the long-term effects of elevated CK-MB levels on patient survival after revascularization procedures.
• To compare CK-MB elevation and its prognostic significance between CABG and PCI.

Main Methods:

• A cohort study assessed three-year cumulative survival in patients undergoing their first CABG or PCI between 1995 and 2000.
• CK-MB levels were determined, and mortality data were tracked using the Social Security Death Index.

Main Results:

• CK-MB elevation was significantly more frequent in CABG patients (90%) compared to PCI patients (38%).
• Elevated CK-MB exceeding 10x the upper limit of normal (ULN) was an independent predictor of mortality in both CABG and PCI groups.
• Key predictors of mortality included chronic renal insufficiency, advanced age, low ejection fraction, and undergoing PCI.

Conclusions:

• Creatine kinase-MB isoform elevation is a frequent occurrence post-revascularization, particularly after CABG.
• Extensive CK-MB elevation is independently associated with increased three-year mortality.
• Proactive identification and management of patients with high CK-MB levels post-revascularization may enhance patient outcomes.