Prognostic Significance of Time Between Balloon and Peak CK-MB in AMI Patients Undergoing Primary PCI

BACKGROUND: Peak creatine kinase-MB (CK-MB) level is an established predictor of clinical outcomes following acute myocardial infarction (AMI). However, the significance of the duration between balloon inflation and peak CK-MB level (BP time) after primary percutaneous coronary intervention (PCI) remains underexplored in terms of prognostic impact. OBJECTIVES: This study aimed to elucidate the relationship between BP time and prognostic outcomes in patients with AMI. METHODS: In this multicenter observational study, 935 AMI patients who underwent primary PCI and achieved TIMI flow grade 3 on final angiography were included. CK-MB levels were measured systematically at admission and at 3-hour intervals post-PCI. Based on a BP time threshold of 553 minutes, patients were categorized into 2 groups: the long BP-time group (n = 183) and the short BP-time group (n = 752). RESULTS: The mean age of the patients was 67 years, with a median BP time of 334 minutes (Q1-Q3: 248-491 minutes). The long BP-time group exhibited a higher prevalence of male patients and a history of prior PCI. Cardiovascular mortality was significantly greater in the long BP-time group (log-rank test: P = 0.002). Multivariable Cox regression analysis indicated that a prolonged BP time was independently associated with increased cardiovascular mortality (HR: 2.63; 95% CI: 1.19-5.78). CONCLUSIONS: Our findings reveal a significant association between BP time and 1-year cardiovascular mortality in patients with AMI. As a readily assessable parameter, BP time can be a valuable tool for early mortality risk stratification in patients post-primary PCI. (Prognostic Implications of Time between Balloon to Peak Creatinine Kinase-MB in patients with Acute Myocardial Infarction Undergoing Primary PCI: Multicenter Cohort Study; UMIN000049942).