Creatine kinase-MB enzyme elevation following successful saphenous vein graft intervention is associated with late mortality

Article

关键词: PERCUTANEOUS CORONARY INTERVENTIONS;    MYOCARDIAL-INFARCTION;    ANGIOPLASTY;    REVASCULARIZATION;    ATHERECTOMY;    RELEASE;   

DOI  :  10.1161/01.CIR.100.24.2400

来源: SCIE

【 摘 要 】

Background-Although the risk for development of creatine kinase (CK-MB) elevation after saphenous vein graft (SVG) intervention is high, its prognostic significance remains unknown. This study evaluated the impact of periprocedural CK-MB elevation on late clinical events following successful SVG angioplasty. Methods and Results-We studied 1056 consecutive patients with successful (defined by angiographic success and absence of major complications) intervention of 1693 SVG lesions. These patients were grouped as normal CK-MB (n=556), minor CK-MB rise (CK-MB 1 to 5 times normal, n=339), and major CK-MB rise (CK-MB >5 times normal, n=161). There were no differences in major clinical events at 30-day follow-up among the 3 groups. However, 1-year mortality was 4.8%, 6.5%, and 11.7%, respectively, P<0.05 (ANOVA). Even within a population without any intraprocedure or in-hospital complications (n=727, 69% of the overall cohort), 1-year mortality remained significantly higher with CK-MB elevation: 2.4%, 5.5%, and 10.7%, respectively, P<0.05 (ANOVA). Multivariate analysis revealed major CK-MB elevation as the strongest independent predictor of late mortality (odds ratio 3.3, with 95% CI 1.7 to 6.2), followed by diabetes mellitus (odds ratio 2.6, with 95% CI 1.5 to 4.5). Conclusions-Major CK-MB elevation occurs after 15% of otherwise successful SVG interventions and is associated with increased late mortality.

【 授权许可】

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