Incidence and mechanism of creatine kinase-MB enzyme elevation after coronary intervention with different devices

Catheter Cardiovasc Interv. 1999 Oct;48(2):123-9. doi: 10.1002/(sici)1522-726x(199910)48:2<123::aid-ccd1>3.0.co;2-o.

Abstract

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.

Publication types

  • Comparative Study

MeSH terms

  • Abciximab
  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary / instrumentation*
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / adverse effects
  • Atherectomy, Coronary / instrumentation*
  • Coronary Disease / enzymology
  • Coronary Disease / therapy*
  • Creatine Kinase / blood*
  • Equipment Design
  • Female
  • Humans
  • Immunoglobulin Fab Fragments / administration & dosage
  • Immunoglobulin Fab Fragments / adverse effects
  • Isoenzymes
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / enzymology
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / adverse effects
  • Prospective Studies
  • Risk Factors
  • Stents*

Substances

  • Antibodies, Monoclonal
  • Immunoglobulin Fab Fragments
  • Isoenzymes
  • Platelet Aggregation Inhibitors
  • Creatine Kinase
  • Abciximab