Key result
Serum CK-MB predicts myocardial injury in highlanders with pulmonary hypertension with ~0.75 AUC.
Why the study?
Myocardial injury with pulmonary hypertension is a severe pathology at high altitude, but clinical characteristics and diagnostic value of myocardial markers in this setting are not well described.
Does CK-MB predict the occurrence of myocardial injury in high-altitude patients with pulmonary hypertension?
Observational (n=231)
No
Does CK-MB predict the occurrence of myocardial injury in high-altitude patients with pulmonary hypertension?
Effect estimate: AUC 0.749
p-value: p=0.000
CK-MB is a convenient and efficient marker that predicts myocardial injury in patients with pulmonary hypertension exposed to high altitude hypoxia.
CK-MB may predict myocardial injury in highlanders with pulmonary hypertension; hypothesis-generating, requires prospective validation before clinical use.
Background High altitude environment can give rise to Myocardial injury (MI) mainly because of hypoxia, where MI with pulmonary hypertension (PH) is one of the severe pathologies. In the present study, we intend to explore clinical characteristics of MI in patients with PH at high altitude and diagnostic value of various myocardial markers. Methods Consecutive patients at the altitude of 3650m were selected into this retrospective study. Clinical and biochemical data were collected. According to the results of Cardiac troponin I (cTnI), patients were divided into MI group and non-MI group. Results A total of 231 patients were enrolled in this study. MI occurred in 29 patients (12.6%). We found that body mass index (BMI, P =0.045), left ventricular end-diastolic dimension (LVEDD, P =0.005), and serum level of creatine kinase-MB (CK-MB, P =0.001) in MI group were significantly higher than that in non-MI group. Spearman correlation analysis revealed that cTnI have a significant positive correlation with CK-MB (P=0.000) and LDH ( P <0.001) instead of aspartate aminotransferase (AST). A receiver operating characteristic (ROC) curve was drawn to demonstrate that CK-MB could significantly predict the occurrence of MI with an area under the curve (AUC) of 0.749 ( P =0.000), and the level of 3.035 (sensitivity = 59.3%, specificity = 90.5%) was optimal cutoff value. Conclusion The incidence of MI with PH is high in highlander. As a convenient and efficient marker, CK-MB is closely associated with cTnI and have a predict role in the occurrence of MI with PH under expose to high altitude hypoxia.
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Zhao et al. (2023) conducted an observational in Pulmonary hypertension at high altitude (n=231). Creatine kinase-MB (CK-MB) was evaluated on Prediction of myocardial injury occurrence (AUC 0.749, p=0.000). Serum CK-MB levels significantly predicted the occurrence of myocardial injury in highlanders with pulmonary hypertension, demonstrating an area under the curve of 0.749.
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