[Clinical and angiographic predictors of creatine kinase enzyme elevation after successful coronary stent implantation: effects on subsequent target vessel revascularization].
OBJECTIVE
The aims of the present study are to evaluate clinical, angiographic, and procedural determinants of creatine kinase (CK) elevation following successful coronary stent implantation, and to assess the relationship between postprocedural CK release and subsequent target vessel revascularization.


METHODS
Study population was composed of 400 consecutive patients who underwent successful coronary stent implantation. Forty-six patients (11.5%) had CK enzyme levels >2 times the upper limit of normal. This group was compared to 100 patients with no CK release after stenting.


RESULTS
Baseline, angiographic and procedural characteristics did not differ between patients with and without postprocedural CK elevation. The significant predictors of CK elevation by multiple logistic regression analysis are unstable angina (p<0.001, OR=5.62 with 95% CI of 2.35-13.45), multiple stenting (p=0.04, OR=2.55 with 95% CI of1.02-6.40) and side branch occlusion (p=0.03,OR=12.20 with 95% CI of 1.22-121.71). By multivariate analysis, postprocedural CK release was found to be a significant determinant of subsequent target vessel revascularization (p=0.032,OR=3.84 with 95% CI of 1.12-13.18).


CONCLUSIONS
Our results indicate that side branch occlusion, implantation of > 1 stents per lesion and coronary stenting in unstable angina pectoris are strong predictors of postprocedural CK release. There is a significant relationship between postprocedural CK elevation and subsequent target vessel revascularization.
Babalik
Erhan
E
Istanbul Universitesi Kardiyoloji Enstitüsü, Kardiyoloji Anabilim Dali, Istanbul. erhanbabalik@yahoo.com
Orta
Kadriye
K
Gürmen
Tevfik
T
Okçün
Bariş
B
Gülbaran
Murat
M
Oztürk
Servet
S
D000368:Aged; D000787:Angina Pectoris; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000401:mortality / Q000628:therapy*; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D012086:Reoperation; D015607:Stents
D003402:Creatine Kinase