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- Title
Long-Term Prognostic Value of Creatine Kinase-Myocardial Band Mass after Cardiac Surgery in Low-Risk Patients with Stable Angina.
- Authors
Vikenes, Kjell; Andersen, Knut S.; Melberg, Tor; Farstad, Mikael; Nordrehaug, Jan Erik
- Abstract
Objectives: The long-term prognostic value (>5 years) of elevated cardiac biomarkers after elective cardiac surgery is not clear. Most previous studies have included high-risk, unstable patients. The aim of this study was to determine the prognostic value of creatine kinase-myocardial band (CK-MB) mass after elective cardiac surgery in low-risk patients with stable angina. Methods: A total of 230 consecutive patients undergoing cardiac surgery were included in the final analysis. Blood samples were drawn just before and 1–3 and 4–8 h after the procedure, and every morning thereafter for 3 days. Using a cutoff value of 5 times the reference, 100 patients (43.6%) had peak CK-MB mass values ≥25 μg/l, and 130 patients had values <25 μg/l (defined as controls). No patient developed new Q waves on ECG. The median follow-up time was 95 months. Results: All-cause mortality and readmission for acute coronary syndromes were more frequent in the high-CK-MB group (30.0 vs. 17.9%, p = 0.022), as was target vessel revascularization (20.6 vs. 5.4%). Comparing the quartiles of peak CK-MB values in a Kaplan-Meier survival plot, event-free survival for the upper quartile (n = 60) was 68.3%, and for the lower quartile (n = 55), it was 83.6% (p = 0.046). In a multivariate logistic regression analysis, high CK-MB and ejection fraction were the only variables independently related to reduced event-free survival. Conclusions: CK-MB values ≥5 times the reference after elective cardiac surgery are associated with reduced long-term event-free survival. Copyright © 2008 S. Karger AG, Basel
- Subjects
CARDIAC surgery; PROGNOSTIC tests; CREATINE kinase; BIOMARKERS; ELECTIVE surgery
- Publication
Cardiology, 2009, Vol 113, Issue 2, p122
- ISSN
0008-6312
- Publication type
Article
- DOI
10.1159/000177949