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Elevation of serum creatine phosphokinase in hospitalized patients

Khalil A Amir1, Sydney X Chen, Ravi K Bobba

  • 1Geriatrics and Palliative Care, University of Virginia Health, Charlottesville, Virginia, USA.

The American Journal of the Medical Sciences
|September 24, 2009
PubMed

Insights

Patients with elevated creatine phosphokinase (CPK) levels, whether cardiac or noncardiac, face significant mortality risks. Noncardiac CPK elevations are more common and have mortality rates comparable to cardiac elevations, with age and renal issues being key predictors.

Area of Science:

  • Cardiology
  • Biochemistry
  • Clinical Medicine

Background:

  • Clinical characteristics and outcomes of patients with significant serum creatine phosphokinase (CPK) elevations are not well described.
  • Distinguishing between cardiac and noncardiac CPK elevations is crucial for understanding patient prognoses.

Purpose of the Study:

  • To describe the clinical characteristics and outcomes of patients with significant noncardiac and cardiac serum CPK elevations.
  • To compare the mortality rates associated with noncardiac versus cardiac CPK elevations.

Main Methods:

  • Retrospective analysis of 158 inpatients with CPK elevation >1000 IU/L.
  • Included 137 patients with CPK elevations attributed to noncardiac or cardiac etiologies.
  • Analyzed clinical characteristics and 30-day, 3-month, and 1-year all-cause mortality rates.

Main Results:

  • Noncardiac CPK (NCCPK) elevation occurred in 69% of patients, while cardiac CPK (CCPK) elevation occurred in 31%.
  • One-year mortality was 26.6% for NCCPK and 37.2% for CCPK.
  • Older age, higher blood urea nitrogen, and creatinine levels were associated with increased mortality in both groups.

Conclusions:

  • NCCPK elevation is more frequent than CCPK elevation in a veteran population.
  • One-year mortality rates for NCCPK and CCPK elevations are comparable.
  • Age and renal insufficiency are major predictors of mortality in patients with elevated CPK levels.
Abstract

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