Abstract
Moderate elevation of creatine kinase (CK) MB isoform is common following otherwise successful percutaneous coronary revascularization, and is frequently interpreted as evidence of a non-Q-wave myocardial infarction. It is not clear, however, whether elevation of CK MB isoform carries sufficient adverse clinical impact to be categorized as a "major" complication. We therefore explored the incidence and clinical consequence of elevation of CK MB isoform in a consecutive series of 565 patients who had otherwise successful directional coronary atherectomy (n = 274) or stenting (n = 291), and were followed for a mean of 2 years. Of this cohort, 11.5% had postprocedure elevation of the CK MB isoform above normal (10 IU/liter). These patients tended to be older and to have undergone atherectomy of a de novo lesion with adverse morphology (thrombus, calcification, eccentricity). Patients with elevation of CK MB isoform following otherwise successful revascularization generally showed no adverse long-term sequelae (death, recurrent myocardial infarction, repeat revascularization) compared with patients without elevation of CK MB isoform. Only 2.3% of the patients who had CK MB isoform release >50 IU/liter demonstrated a trend (p = 0.08) toward decreased late survival, compared with patients without CK MB isoform elevation. While minor CK MB isoform elevation is common (11.5%) after successful coronary stenting or directional atherectomy, it generally has no adverse clinical consequences, and should not be considered a major complication. Greater CK MB isoform elevations (>50 IU/liter) are less common (2.3%), but appear to adversely affect long-term clinical outcome and should thus probably be considered along with Q-wave myocardial infarction as a major complication in reporting new device results.
| Original language | English |
|---|---|
| Pages (from-to) | 748-754 |
| Number of pages | 7 |
| Journal | The American journal of cardiology |
| Volume | 74 |
| Issue number | 8 |
| DOIs | |
| State | Published - Oct 15 1994 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
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Elevation of the creatine kinase myocardial isoform following otherwise successful directional coronary atherectomy and stenting. / Kugelmass, Aaron D.; Cohen, David J.; Moscucci, Mauro; Piana, Robert N.; Senerchia, Cynthia; Kuntz, Richard E.; Baim, Donald S.
In: The American journal of cardiology, Vol. 74, No. 8, 15.10.1994, p. 748-754.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Elevation of the creatine kinase myocardial isoform following otherwise successful directional coronary atherectomy and stenting
AU - Kugelmass, Aaron D.
AU - Cohen, David J.
AU - Moscucci, Mauro
AU - Piana, Robert N.
AU - Senerchia, Cynthia
AU - Kuntz, Richard E.
AU - Baim, Donald S.
PY - 1994/10/15
Y1 - 1994/10/15
N2 - Moderate elevation of creatine kinase (CK) MB isoform is common following otherwise successful percutaneous coronary revascularization, and is frequently interpreted as evidence of a non-Q-wave myocardial infarction. It is not clear, however, whether elevation of CK MB isoform carries sufficient adverse clinical impact to be categorized as a "major" complication. We therefore explored the incidence and clinical consequence of elevation of CK MB isoform in a consecutive series of 565 patients who had otherwise successful directional coronary atherectomy (n = 274) or stenting (n = 291), and were followed for a mean of 2 years. Of this cohort, 11.5% had postprocedure elevation of the CK MB isoform above normal (10 IU/liter). These patients tended to be older and to have undergone atherectomy of a de novo lesion with adverse morphology (thrombus, calcification, eccentricity). Patients with elevation of CK MB isoform following otherwise successful revascularization generally showed no adverse long-term sequelae (death, recurrent myocardial infarction, repeat revascularization) compared with patients without elevation of CK MB isoform. Only 2.3% of the patients who had CK MB isoform release >50 IU/liter demonstrated a trend (p = 0.08) toward decreased late survival, compared with patients without CK MB isoform elevation. While minor CK MB isoform elevation is common (11.5%) after successful coronary stenting or directional atherectomy, it generally has no adverse clinical consequences, and should not be considered a major complication. Greater CK MB isoform elevations (>50 IU/liter) are less common (2.3%), but appear to adversely affect long-term clinical outcome and should thus probably be considered along with Q-wave myocardial infarction as a major complication in reporting new device results.
AB - Moderate elevation of creatine kinase (CK) MB isoform is common following otherwise successful percutaneous coronary revascularization, and is frequently interpreted as evidence of a non-Q-wave myocardial infarction. It is not clear, however, whether elevation of CK MB isoform carries sufficient adverse clinical impact to be categorized as a "major" complication. We therefore explored the incidence and clinical consequence of elevation of CK MB isoform in a consecutive series of 565 patients who had otherwise successful directional coronary atherectomy (n = 274) or stenting (n = 291), and were followed for a mean of 2 years. Of this cohort, 11.5% had postprocedure elevation of the CK MB isoform above normal (10 IU/liter). These patients tended to be older and to have undergone atherectomy of a de novo lesion with adverse morphology (thrombus, calcification, eccentricity). Patients with elevation of CK MB isoform following otherwise successful revascularization generally showed no adverse long-term sequelae (death, recurrent myocardial infarction, repeat revascularization) compared with patients without elevation of CK MB isoform. Only 2.3% of the patients who had CK MB isoform release >50 IU/liter demonstrated a trend (p = 0.08) toward decreased late survival, compared with patients without CK MB isoform elevation. While minor CK MB isoform elevation is common (11.5%) after successful coronary stenting or directional atherectomy, it generally has no adverse clinical consequences, and should not be considered a major complication. Greater CK MB isoform elevations (>50 IU/liter) are less common (2.3%), but appear to adversely affect long-term clinical outcome and should thus probably be considered along with Q-wave myocardial infarction as a major complication in reporting new device results.
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U2 - 10.1016/0002-9149(94)90427-8
DO - 10.1016/0002-9149(94)90427-8
M3 - Article
C2 - 7942542
AN - SCOPUS:0027971652
VL - 74
SP - 748
EP - 754
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 8
ER -