Incidence and mechanism of creatine kinase-MB enzyme elevation after coronary intervention with different devices.
The present study was conducted to evaluate the incidence of CK-MB elevation and to identify the possible mechanisms of CK-MB release after various coronary interventional devices. We prospectively studied 1,675 consecutive patients following various coronary interventions for CK-MB elevation, from January 1997 to February 1998 and followed them for in-hospital events. CK-MB elevation was detected in 313 patients (18.7%); with 1-3 x normal in 12.8%, 3-5 x normal in 3.5%, and >5 x normal in 2.4%. CK-MB elevation was more common after nonballoon devices (19.5% vs. 11.5% after balloon angioplasty; P < 0.01). Among the newer nonballoon devices, rotational atherectomy alone had a lower CK-MB elevation compared to stent-alone group (16.0% vs. 20.5%; P = 0.07). On univariate analysis, due to selective use of abciximab in high-risk coronary interventions, there was higher incidence of CK-MB elevation with abciximab (24.5% vs. 15.0% without abciximab; P < 0.01). Some kind of procedural complication was observed in 49% of the CK-MB elevation group, with side-branch closure being the most frequent (22.7%). In conclusion, CK-MB elevation is common after successful coronary interventions and is higher after nonballoon devices. Cathet. Cardiovasc. Intervent. 48:123-129, 1999.
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Cardiac Catheterization of the Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Hospital, New York, New York 10029, USA.
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Marmur
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Bertea
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Dangas
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Cocke
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D000077284:Abciximab; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects; D017225:Atherectomy, Coronary / Q000295:instrumentation*; D003327:Coronary Disease / Q000201:enzymology / Q000628:therapy*; D003402:Creatine Kinase / Q000097:blood*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage / Q000009:adverse effects; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000201:enzymology; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D012307:Risk Factors; D015607:Stents
D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D007527:Isoenzymes; D010975:Platelet Aggregation Inhibitors; D003402:Creatine Kinase; D000077284:Abciximab