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Comparative prognostic value of postprocedural creatine kinase myocardial band and high‐sensitivity troponin T in patients with non‐ST‐segment elevation myocardial infarction undergoing percutaneous coronary intervention
Author(s) -
Ndrepepa Gjin,
Colleran Roisin,
Braun Siegmund,
Xhepa Erion,
Hieber Julia,
Cassese Salvatore,
Fusaro Massimiliano,
Kufner Sebastian,
Laugwitz KarlLudwig,
Schunkert Heribert,
Kastrati Adnan
Publication year - 2018
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27105
Subject(s) - medicine , percutaneous coronary intervention , myocardial infarction , conventional pci , hazard ratio , cardiology , creatine kinase , troponin t , troponin , confidence interval , troponin complex
Objectives We aimed to assess the prognostic value of postprocedural creatine kinase myocardial band (CK‐MB) and cardiac troponin (cTn) in patients with non‐ST‐segment elevation myocardial infarction (NSTEMI). Background : Whether postprocedural CK‐MB or cTn is a better biomarker to stratify the risk after percutaneous coronary intervention (PCI) remains unknown. Methods : This study included 2,077 patients with NSTEMI undergoing early PCI. Peak postprocedural values of CK‐MB and high‐sensitivity cTn T (hs‐cTnT) were analyzed. The primary outcome was 3‐year mortality. Results : The median values of peak postprocedural CK‐MB and hs‐cTnT were 18.3 U L −1 and 0.140 µg L −1 , respectively. Overall, 211 patients died during follow‐up. There were 129 deaths in patients with CK‐MB >the median value and 82 deaths in those with CK‐MB ≤the median value (Kaplan–Meier estimates of 3‐year mortality, 18.9% and 14.0%, respectively; hazard ratio [HR] = 1.52, 95% confidence interval [CI] 1.16–2.01; P < 0.001). There were 134 deaths in patients with hs‐cTnT >the median value and 77 deaths in patients with hs‐cTnT ≤the median value (Kaplan–Meier estimates of 3‐year mortality, 19.9% and 13.2%, respectively; HR = 1.90 [1.44–2.52]; P < 0.001). After adjustment, peak postprocedural CK‐MB (adjusted HR = 1.05 [1.02–1.07], P < 0.001 for each 24 U L −1 increment) and hs‐cTnT (adjusted HR = 1.12 [1.01–1.25], P = 0.037 for each unit higher log hs‐cTnT) remained independently associated with the risk of 3‐year mortality. The C‐statistic(s) of the model with CK‐MB and hs‐cTnT were 0.789 [0.757–0.817] and 0.793 [0.762–0.821], respectively ( P = 0.585). Conclusion : In patients with NSTEMI undergoing early PCI, peak postprocedural CK‐MB and hs‐cTnT are independently associated with the risk of 3‐year mortality. © 2017 Wiley Periodicals, Inc.