Incidence, predictors, and significance of abnormal cardiac enzyme rise in patients treated with bypass surgery in the arterial revascularization therapies study (ARTS).

Abstract:

BACKGROUND:Although it has been suggested that elevation of CK-MB after percutaneous coronary intervention is associated with adverse clinical outcomes, limited data are available in the setting of coronary bypass grafting. The aim of the present study was to determine the incidence, predictors, and prognostic significance of CK-MB elevation following multivessel coronary bypass grafting (CABG). METHODS AND RESULTS:The population comprises 496 patients with multivessel coronary disease assigned to CABG in the Arterial Revascularization Therapies Study (ARTS). CK-MB was prospectively measured at 6, 12, and 18 hours after the procedure. Thirty-day and 1-year clinical follow-up were performed. Abnormal CK-MB elevation occurred in 61.9% of the patients. Patients with increased cardiac-enzyme levels after CABG were at increased risk of both death and repeat myocardial infarction within the first 30 days (P=0.001). CK-MB elevation was also independently related to late adverse outcome (P=0.009, OR=0.64). CONCLUSIONS:Increased concentrations of CK-MB, which are often dismissed as inconsequential in the setting of multivessel CABG, appear to occur very frequently and are associated with a significant increase in both repeat myocardial infarction and death beyond the immediate perioperative period.

journal_name

Circulation

journal_title

Circulation

authors

Costa MA,Carere RG,Lichtenstein SV,Foley DP,de Valk V,Lindenboom W,Roose PC,van Geldorp TR,Macaya C,Castanon JL,Fernandez-Avilèz F,Gonzáles JH,Heyer G,Unger F,Serruys PW

doi

10.1161/hc4701.099789

subject

Has Abstract

pub_date

2001-11-27 00:00:00

pages

2689-93

issue

22

eissn

0009-7322

issn

1524-4539

journal_volume

104

pub_type

临床试验,杂志文章,多中心研究,随机对照试验
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