Frequency and long-term impact of myonecrosis after coronary stenting
Why the study?
Does peri-procedural myonecrosis (creatine kinase MB elevation) after coronary stenting increase the risk of long-term major adverse ischaemic events and mortality in patients undergoing planned coronary stenting?
Population
3478 patients undergoing planned coronary stenting
Comparison
Peri-procedural myonecrosis stratified by peak… vs Normal creatine kinase MB levels
Design
Cohort
Follow-up
average 15+/-15 months (range 1-72)
Authors
Discussion
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Member takes
Implication
CK-MB elevation after stenting was associated with higher long-term mortality; extends prior observational data but leaves causal effects and practice change open.
Key Points
- This research aims to understand how often creatine kinase MB elevation occurs after coronary stenting and its association with long-term ischaemic outcomes.
- Evaluated 3478 patients undergoing coronary stenting, divided into five strata based on peak creatine kinase MB levels.
- Major adverse ischaemic events were tracked during an average follow-up of 15 months, with logistic regression used for analysis.
- Creatine kinase MB elevation above normal occurred in 24% of participants, with 5.3% exceeding five times the upper limit.
- Actuarial mortality rates ranged significantly across strata, with the highest elevation group at 29.3%, P<0.001.
- Higher levels of creatine kinase MB were linked to increased major ischaemic events, especially in patients with the highest elevation.
Structured PICO
Does peri-procedural myonecrosis (creatine kinase MB elevation) after coronary stenting increase the risk of long-term major adverse ischaemic events and mortality in patients undergoing planned coronary stenting?
P
Population
3478 patients undergoing planned coronary stenting (15% graft intervention, 61% received platelet glycoprotein IIb/IIIa receptor inhibitors)
I
Intervention
Peri-procedural myonecrosis (creatine kinase MB elevation) stratified by peak levels (1-3x, 3-5x, 5-10x, and >10x upper limit of normal)
C
Comparator
Normal creatine kinase MB levels
O
Outcome
Major adverse ischaemic events and actuarial mortalityhard clinical
Peri-procedural myonecrosis after coronary stenting is frequent and strongly associated with increased long-term mortality and major ischaemic events, particularly at >10x the upper limit of normal.
Cite This Study
Sorin J. Brener (2002) studied this question.