Prognostic implication of creatine kinase elevation following elective coronary artery interventions
T Q Kong1, C J Davidson, S N Meyers
1Department of Internal Medicine, Division of Cardiology, Northwestern University Medical School, Chicago, Ill, USA.
JAMA
|February 12, 1997
Summary
Creatine kinase (CK) elevation after percutaneous transluminal coronary angioplasty (PTCA) indicates higher late cardiac mortality risk. Even mild CK increases signal a significantly greater risk of cardiac death post-procedure.
Area of Science:
- Cardiology
- Biomarkers
- Interventional Cardiology
Background:
- Percutaneous transluminal coronary angioplasty (PTCA) is a common procedure for coronary artery disease.
- The prognostic significance of creatine kinase (CK) elevation post-PTCA requires further clarification.
Purpose of the Study:
- To investigate the prognostic value of creatine kinase (CK) elevation following elective percutaneous transluminal coronary angioplasty (PTCA).
Main Methods:
- Retrospective cohort study including 253 patients with CK elevation and 120 controls.
- Follow-up duration exceeded 3.5 years.
- Outcomes assessed included cardiac mortality and myocardial infarction.
Main Results:
- Patients with CK elevation post-PTCA had significantly greater cardiac mortality (P=.02).
- Cardiac mortality increased with higher peak CK levels (P=.007).
- Multivariate analysis identified higher peak CK and lower ejection fraction as key predictors of cardiac mortality.
Conclusions:
- Creatine kinase elevation after elective PTCA is an independent predictor of increased late cardiac mortality.
- Even minor CK elevations are associated with significantly increased risk for late cardiac death.
- This finding holds true irrespective of clinical factors, disease severity, or procedural characteristics.
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