Creatine kinase-MB fraction elevation after percutaneous coronary intervention in patients with chronic renal failure

Luis Gruberg, Roxana Mehran, Ron Waksman, George Dangas, Shmuel Fuchs, Hongsheng Wu, Kenneth M. Kent, Augusto D. Pichard, Lowell F. Satler, Gregg W. Stone, Martin B. Leon

Research output: Contribution to journalArticlepeer-review

Abstract

We evaluated the short- and long-term clinical outcomes of 326 consecutive patients with chronic renal failure, not on dialysis, who had creatine kinase (CK)-myocardial band (MB) fraction elevation after successful percutaneous coronary intervention in a native coronary artery. Based on peak CK-MB levels measured after intervention, patients were divided into 3 groups: no elevation (group 1, n = 184), 1 to 3 × upper normal levels (group 2, n = 72), and >3 × upper normal levels (group 3, n = 70). Baseline clinical and angiographic characteristics were similar among the 3 groups. Angiographic success was similar among the 3 groups, although there was a significantly higher use of intra-aortic balloon pump in patients who had postprocedural CK-MB >3 × normal values and a higher rate of in-hospital complications, i.e., repeat catheterization, repeat target lesion intervention, pulmonary edema, renal function deterioration, emergency dialysis, and major bleeding complications. At 1-year follow-up, mortality rates were significantly higher in these patients (35.4% vs 22.0% for patients with CK-MB 1 to 3 × normal values and 16.7% for patients without CK-MB elevation, p = 0.007). Multivariate analysis showed that CK-MB >3 × normal (odds ratio 3.04; 95% confidence interval 1.41 to 6.57, p = 0.005) and intra-aortic balloon pump (odds ratio 1.49; confidence interval 1.15 to 1.93, p = 0.002) were independent predictors of late mortality. Therefore, patients with chronic renal failure who had CK-MB elevation >3 × the upper normal limit after a successful percutaneous coronary intervention had a higher incidence of in-hospital complications and a significantly higher mortality rate at 1-year follow-up than patients without CK-MB elevation or with <3 × normal CK-MB elevation.

Original languageEnglish
Pages (from-to)1356-1360
Number of pages5
JournalAmerican Journal of Cardiology
Volume87
Issue number12
DOIs
StatePublished - 15 Jun 2001
Externally publishedYes

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