Admission creatine kinase as a prognostic marker in acute myocardial infarction

Area of Science:

• Cardiology
• Biochemistry
• Clinical Medicine

Background:

• Acute myocardial infarction (AMI) poses a significant health burden globally.
• Accurate prognostic markers are crucial for managing AMI patients and predicting long-term outcomes.
• Biochemical markers like creatine kinase (CK) and troponin T (TnT) are commonly used in AMI diagnosis and risk stratification.

Purpose of the Study:

• To evaluate the prognostic significance of admission creatine kinase (CK) levels in Pakistani patients with acute myocardial infarction (AMI).
• To determine if combining CK with troponin T (TnT) enhances the prediction of long-term adverse cardiac events.
• To compare the predictive power of CK and TnT for cardiac events and mortality.

Main Methods:

• A prospective cohort study involving 186 consecutive AMI patients eligible for streptokinase (SK) treatment.
• Serum/plasma CK and TnT levels were measured at admission.
• Clinical outcomes were monitored over a mean follow-up period of 24.12 ± 3.75 months.

Main Results:

• Admission CK levels were significantly associated with subsequent cardiac events (P < 0.01) and mortality (P < 0.04).
• Patients with above-normal CK levels had 3.46 times higher odds of a cardiac event compared to those with normal levels.
• Positive TnT levels were associated with 4.6 times higher odds of mortality; however, combined CK and TnT did not improve prognostic predictability.

Conclusions:

• Admission CK is a superior prognostic marker for predicting cardiac events in AMI patients.
• Troponin T (TnT) is a more effective predictor of mortality in the medium term (nearly 2 years).
• The combined use of CK and TnT does not offer additional predictive value for adverse cardiac events in this cohort.