title: Relation between coronary atherosclerotic plaque burden and cardiac enzyme elevation following percutaneous coronary intervention.
abstract: Several studies have reported that elevation of cardiac creatine kinase (CK) enzymes after percutaneous coronary intervention (PCI) is associated with an increase in cardiac morbidity and mortality during follow-up. However, it remains unclear if enzyme elevation contributes to the adverse outcomes or is simply a marker for adverse events. We conducted a case-control study to determine if angiographically determined atherosclerotic plaque burden correlated with CK elevation. Patients (cases, n = 23) with CK elevation after PCI were identified along with 46 age- and gender-matched controls without CK elevation. Detailed angiographic analysis quantified the percentage of coronary artery length with any luminal irregularity, a surrogate for plaque burden. The CK elevation group was characterized by a greater number of smokers (65% vs 33%, p = 0.02), more thrombus-containing lesions (22% vs 2.2%, p = 0.014), and more frequent abrupt closure (13% vs 0%, p = 0.03). In addition, the case group had a 50% increase in atherosclerotic plaque burden compared with controls (30 +/- 14% vs 20 +/- 14%, p = 0.006). These data suggest that CK elevation after PCI is a marker for more extensive atherosclerosis, which may explain the worse prognosis of these patients.
authors.affiliation: Department of Medicine (Cardiovascular Medicine), Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York 10461, USA.
authors.forename: P K
authors.initials: PK
authors.lastname: Kanaparti
authors.forename: D L
authors.initials: DL
authors.lastname: Brown
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000201:enzymology / Q000401:mortality / Q000628:therapy; D003402:Creatine Kinase / Q000097:blood*; D052279:Creatine Kinase, MB Form; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D007527:Isoenzymes; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form