TY - JOUR
T1 - Creatine kinase-MB enzyme elevation following successful saphenous vein graft intervention is associated with late mortality
AU - Hong, Mun K.
AU - Mehran, Roxana
AU - Dangas, George
AU - Mintz, Gary S.
AU - Lansky, Alexandra J.
AU - Pichard, Augusto D.
AU - Kent, Kenneth M.
AU - Satler, Lowell F.
AU - Stone, Gregg W.
AU - Leon, Martin B.
PY - 1999/12/14
Y1 - 1999/12/14
N2 - 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.
AB - 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.
KW - Angioplasty
KW - Creatine kinase
KW - Myocardial infarction
KW - Stents
UR - http://www.scopus.com/inward/record.url?scp=0032786887&partnerID=8YFLogxK
U2 - 10.1161/01.CIR.100.24.2400
DO - 10.1161/01.CIR.100.24.2400
M3 - Article
C2 - 10595951
AN - SCOPUS:0032786887
SN - 0009-7322
VL - 100
SP - 2400
EP - 2405
JO - Circulation
JF - Circulation
IS - 24
ER -