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Titolo:
Prognostic value of recurrent episodes of creatine kinase-MB elevation following repeated catheter-based coronary interventions
Autore:
Kornowski, R; Fuchs, S; Hong, MK; Mehran, R; Satler, LF; Pichard, AD; Kent, KM; Stone, GW; Leon, MB;
Indirizzi:
Washington Hosp Ctr, Cardiovasc Res Fdn, Cardiac Catheterizat Lab, Washington, DC 20010 USA Washington Hosp Ctr Washington DC USA 20010 Lab, Washington, DC 20010 USA
Titolo Testata:
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS
fascicolo: 2, volume: 51, anno: 2000,
pagine: 131 - 137
SICI:
1522-1946(200010)51:2<131:PVOREO>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARDIAC TROPONIN-T; REVASCULARIZATION PROCEDURES; RELEASE; ANGIOPLASTY;
Keywords:
angioplasty; ischemic heart disease; stents; creatine kinase MB;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
15
Recensione:
Indirizzi per estratti:
Indirizzo: Kornowski, R Washington Hosp Ctr, Cardiovasc Res Fdn, Cardiac CatheterizatLab, 110 Irving St NW,Suite 4B-1, Washington, DC 20010 USA Washington HospCtr 110 Irving St NW,Suite 4B-1 Washington DC USA 20010
Citazione:
R. Kornowski et al., "Prognostic value of recurrent episodes of creatine kinase-MB elevation following repeated catheter-based coronary interventions", CATHET C IN, 51(2), 2000, pp. 131-137

Abstract

Creatine kinase-MB (CK-MB) enzyme elevations were shown to affect cardiac prognosis following percutaneous coronary interventions (PCIs). This study examined whether recurrent episodes of CK-MB elevation following repeated PCIs may be associated with a cumulative adverse prognostic risk. We studied767 consecutive patients (age, 64 +/- 11 years; 69% male) who underwent two consecutive PCI procedures on two separate hospitalizations (mean interval, 121 +/- 110 days). Patients were stratified into four groups according to number of episodes of any (> 4 ng/ml) postinterventional CK-MB rise (no elevation, previously elevated, currently elevated, or elevated at the time of both procedures; n = 403, 107, 153, and 104 patients, respectively). In-hospital clinical outcomes (death, Q-MI, and repeat revascularization) and up to 1-year follow-up events were obtained. Recurrent episodes of CK-MB elevation were associated with increased in-hospital mortality (3.8% vs. 0.9%vs. 0% vs. 0%, P = 0.0003), increased cumulative mortality (18.9% vs. 5.9%vs. 4.3% vs. 4.3%, P = 0.0003) and cumulative Q wave MI (8.0% vs. 4.9% vs.1.0% vs. 0.8%, P = 0.005) at 1 year, and lower overall cardiac event-free survival at follow-up (66.8% vs. 80.5% vs. 88.8% vs. 88.8%, P = 0.0001 for patients with twice, current, previous, and no CK-MB elevation, respectively). By multivariate analysis, CK-MB elevated at the time of both procedures, was the strongest independent predictor for cumulative mortality (OR 3.4,95% CI 1.6-7.1, P = 0.001) or any adverse cardiac events (OR 2.6, 95% CI 1.6-4.3, P = 0.0002). We conclude that cumulative episodes of periproceduralCK-MB elevation are associated with an incremental adverse prognostic riskincluding mortality and Q-wave MI. Thus, measures aimed at reducing subsequent CK-MB rise may be warranted in particular among patients with a prior history of PCI related CK-MB elevation. Cathet. Cardiovasc. Intervent 51:131-137, 2000. (C) 2000 Wiley-Liss, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/04/20 alle ore 16:09:28