BACKGROUND: CK-MB elevation after successful percutaneous coronary intervention (PCI) has been associated with an increased risk of adverse clinical events at the long-term follow-up, including death due to cardiac causes. Our objective was to analyze the association between CK-MB elevation and the occurrence of cardiac adverse events at 1-year in patients submitted to elective PCI in a tertiary referral hospital. METHODS: A prospective cohort with 114 consecutive patients, submitted to successful PCI of a single native coronary artery, were analyzed. CK and CK-MB levels were routinely obtained pre-procedure, and 6 and 24 hours post-procedure. Patients were reassessed with follow-up visits and the electrocardiogram was repeated at 6 and 12 months to analyze the incidence of adverse cardiac events (death, Q-wave acute myocardial infarction [AMI], target-vessel revascularization or recurrent ischemia). RESULTS: The patients were divided into two groups according to enzymatic results. Of the 19 (16.7%) patients with CKMB elevation, 11 (57.9%) had an adverse cardiac event at the end of 6 months compared to 21 (22.1%) patients without enzymatic elevation (p = 0.004). At 12 months a trend toward fewer cardiac events was observed in patients with CK-MB elevation, however, not reaching statistical significance for an α = 5% (63.2% vs. 37.9%; p = 0.075). Multivariate analysis showed that CK-MB elevation as an independent predictor of adverse cardiac events at 6 months (odds ratio [OR], 4.34; 95% confidence interval [95% CI], 1.88-10.03; p < 0.001) but not at 12 months (OR, 1.77; 95% CI, 0.773-4.055; p = 0.182). CONCLUSIONS: CK-MB elevation after PCI is associated with increased risk of adverse cardiac events, mainly during the first six-month follow-up.
Creatine kinase, MB form; Angioplasty, transluminal, percutaneous coronary; Follow-up studies; Prognosis
