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Published on: August 8, 2013
Elevated serum creatine kinase predicts first-ever myocardial infarction: a 12-year population-based cohort study in
Makoto Watanabe1, Tomonori Okamura, Yoshihiro Kokubo
1Department of Preventive Cardiology, National Cardiovascular Center, Osaka, Japan. makotow@hsp.ncvc.go.jp
Insights
Elevated serum creatine kinase (s-CK) levels can predict future myocardial infarction (MI) in healthy individuals. This risk is particularly high for those with hypercholesterolemia, suggesting s-CK screening is valuable.
Area of Science:
- Cardiovascular Medicine
- Biomarker Research
- Preventive Cardiology
Background:
- Serum creatine kinase (s-CK) is known to rise post-myocardial infarction (MI).
- The predictive value of pre-MI s-CK levels for incident MI or stroke remains unclear.
- This study investigated elevated s-CK as a predictor for first-ever MI and stroke.
Purpose of the Study:
- To determine if elevated serum creatine kinase (s-CK) predicts first-ever myocardial infarction (MI) or stroke.
- To explore the relationship between s-CK levels and the risk of cardiovascular events in an initially healthy population.
Main Methods:
- Population-based cohort study conducted in a Japanese urban area.
- Included 5026 initially healthy Japanese individuals (2370 men, 2656 women; mean age 54.5 years) with no prior history of MI or stroke.
- Average follow-up of 11.8 years, observing 103 MIs and 168 strokes.
Main Results:
- Elevated s-CK levels (≥200 IU/l) were associated with a 4.18-fold increased hazard ratio for definite MI compared to lower levels (
- No significant association was found between s-CK levels and the risk of stroke.
- A significant interaction between s-CK levels and hypercholesterolemia was observed for definite MI, with risk linearly increasing with s-CK in hypercholesterolemic subjects.
Conclusions:
- Screening for elevated serum creatine kinase (s-CK) levels in healthy Japanese individuals can be a useful tool for predicting future first-ever myocardial infarction (MI).
- The predictive value of elevated s-CK for MI is particularly pronounced in individuals with co-existing dyslipidemia, specifically hypercholesterolemia.
Background:
In myocardial infarction (MI), it is well known that serum creatine kinase (s-CK) increases after onset, but it is unclear whether s-CK elevates before MI onset. The present analysis examined whether elevated s-CK levels predicted first-ever MI or stroke.
Methods:
This study was a population-based cohort study in a Japanese urban area. Study subjects were comprised of 5026 initially healthy Japanese (2370 men and 2656 women, mean age: 54.5 years) without a history of MI or stroke. They were followed-up for 11.8 years on average, and 103 MIs (definite: 45; probable: 58) and 168 strokes (definite: 126; probable: 42) were observed. There was no subject who developed MI just at baseline (the follow-up period among those with definite MI was, at earliest, 0.20 years).
Results:
The adjusted hazard ratio for definite MI was 4.18 (95% confidence interval 1.66-10.53) with s-CK levels of >or=200 IU/l, compared with the reference category (s-CK levels of
Conclusions:
The present study suggested that screening for elevated s-CK levels in initially healthy Japanese subjects was useful to predict first-ever MI in the future, especially in subjects with dyslipidaemia.
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