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Predictors of periprocedural creatine kinase-myocardial band elevation complicating elective percutaneous coronary

Qiangjun Cai1, Kimberly A Skelding, Arthur T Armstrong

  • 1Department of Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA.

The American Journal of Cardiology
|February 24, 2007
PubMed

Insights

Predictors of creatine kinase-MB (CK-MB) increase after percutaneous coronary intervention (PCI) were identified. Chest pain at the procedure

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Biomarkers

Background:

  • Limited data exist on predictors of periprocedural creatine kinase-MB (CK-MB) increase post-elective percutaneous coronary intervention (PCI) in the stenting era.
  • Understanding these predictors is crucial for risk stratification and patient management.

Purpose of the Study:

  • To explore the predictors of periprocedural CK-MB increase following elective PCI.
  • To identify factors associated with minor and major CK-MB elevations after PCI.

Main Methods:

  • Retrospective analysis of 882 patients with normal preprocedural CK-MB undergoing 919 elective PCIs.
  • Patients categorized into normal, minor (1-3x normal), and major (>3x normal) peak CK-MB groups.
  • Logistic regression analysis to identify independent predictors for CK-MB increase.

Main Results:

  • Independent predictors for minor CK-MB increase included thrombus, number of lesions, balloon size, type C lesion, chest pain during procedure, dissection, and side branch occlusion.
  • Independent predictors for major CK-MB increase included chest pain at end of procedure, type C lesion, severe angina, thrombus, and abrupt closure.
  • Chest pain at the end of the procedure was the strongest predictor for major CK-MB increase.

Conclusions:

  • Baseline clinical and angiographic characteristics, along with procedural complications, are associated with periprocedural CK-MB increases after PCI.
  • Patients experiencing chest pain at the end of the procedure face the highest risk of major CK-MB elevation.
  • These findings aid in identifying high-risk patients and optimizing PCI strategies.

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