Cryoprostatectomy consistently elevates serum creatine kinase-MB isoenzyme

Area of Science:

• Cardiology
• Biochemistry
• Urology

Background:

• Serum creatine kinase-MB (CK-MB) is a key biomarker for detecting myocardial infarction (MI).
• Cryoprostatectomy is a surgical procedure for treating prostate conditions in elderly men.
• Assessing cardiac events in patients undergoing non-cardiac surgery requires reliable diagnostic markers.

Purpose of the Study:

• To evaluate the reliability of serum CK-MB as a marker for myocardial infarction (MI) in elderly men following cryoprostatectomy.
• To determine if post-cryoprostatectomy elevations in serum CK-MB are indicative of cardiac injury.

Main Methods:

• Serum CK-MB levels were measured in 38 male patients (mean age 69.1 years) before and at multiple time points after cryoprostatectomy.
• Electrocardiograms (ECGs) were performed pre-operatively, post-anesthesia, and 24 hours post-surgery.
• Lactate dehydrogenase (LDH) and isoenzymes were also analyzed in a subset of patients.

Main Results:

• All cryoprostatectomies were uneventful, with no new ECG changes observed post-surgery.
• Serum CK and CK-MB levels significantly increased after cryoprostatectomy (p < 0.001), peaking at 8 hours.
• CK-MB levels post-procedure were disproportionately higher when measured by gel electrophoresis compared to monoclonal antibody assays, unlike in acute MI.

Conclusions:

• Serum CK-MB is an unreliable indicator of myocardial infarction (MI) in patients who have undergone cryoprostatectomy.
• Elevated CK-MB levels after cryoprostatectomy likely result from the procedure itself, not cardiac damage.
• Alternative diagnostic strategies may be needed to assess for MI in this patient population.