Elevated CK-MB values after routine angioplasty predicts worse long-term prognosis in low-risk patients

Area of Science:

• Cardiology
• Biomarkers
• Interventional Cardiology

Background:

• The long-term prognostic implications of elevated cardiac biomarkers post-elective coronary angioplasty remain unclear, particularly in low-risk patient cohorts.
• Previous studies often included high-risk or unstable patients, limiting generalizability.

Purpose of the Study:

• To assess the prognostic value of elevated creatine kinase-MB (CK-MB) mass (> or = three times the reference) after elective angioplasty in low-risk patients with stable angina.
• To determine if post-procedural CK-MB levels predict long-term event-free survival.

Main Methods:

• A cohort of 278 low-risk patients with stable angina undergoing elective angioplasty was analyzed.
• Patients with elevated baseline CK-MB or recent acute coronary syndrome were excluded.
• Peak CK-MB mass was measured post-procedure; patients were categorized into high CK-MB (>=15 microg/L) and control groups.
• Median follow-up was 80.5 months.

Main Results:

• Nineteen patients (6.8%) had high peak CK-MB levels.
• High CK-MB was associated with significantly higher rates of all-cause mortality, readmission for acute coronary syndromes, and target lesion revascularization (42.1% vs. 22.8%, p=0.034).
• Multivariate analysis identified high CK-MB and prior angioplasty as independent predictors of reduced event-free survival.

Conclusions:

• Elevated CK-MB mass (>= three times the reference) following elective angioplasty is a significant predictor of reduced long-term event-free survival in low-risk patients.
• CK-MB serves as a valuable prognostic indicator for long-term outcomes after elective coronary angioplasty.