TY - JOUR
T1 - Myonecrosis following isolated coronary artery bypass grafting is common and associated with an increased risk of long-term mortality
AU - Marso, Steven P.
AU - Bliven, Brent D.
AU - House, John A.
AU - Muehlebach, Gregory F.
AU - Borkon, A. Michael
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2003/7
Y1 - 2003/7
N2 - Aims We sought to evaluate the risk of long-term mortality with respect to postoperative elevation of the isoenzyme CK-MB following first-time isolated coronary artery bypass grafting (CABG) surgery. Methods Patients undergoing first-time isolated CABG between September 1992 and December 2001, at the Mid America Heart Institute, were included in this registry analysis. A sole CK-MB measurement was obtained at an average of 15.2 h following CABG. The main endpoint was long-term mortality. Results There were 3667 patients included in this registry. The mean follow up was 5.1 years. The event-free survival rate was 80%, 78% and 73%, for the normal, 1-3 and >3 times by ULN groups respectively; log-rank p=0.0058. The event-free survival for the four CK-MB groups was 80%, 78%, 75% and 72% for the normal, 1-3 times, >3-5, and >5 times ULN groups respectively, log-rank p=0.0078. The CK-MB elevation following CABG remained a significant predictor following multivariate adjustment. With a point estimate of 1.04, 95% confidence limits 1.009-1.062, p=0.007. Conclusion Elevation of the isoenzyme CK-MB is an important predictor of long-term mortality following coronary bypass grafting. These data support routine use of creatinine kinase measurement following bypass surgery to further delineate long-term risk.
AB - Aims We sought to evaluate the risk of long-term mortality with respect to postoperative elevation of the isoenzyme CK-MB following first-time isolated coronary artery bypass grafting (CABG) surgery. Methods Patients undergoing first-time isolated CABG between September 1992 and December 2001, at the Mid America Heart Institute, were included in this registry analysis. A sole CK-MB measurement was obtained at an average of 15.2 h following CABG. The main endpoint was long-term mortality. Results There were 3667 patients included in this registry. The mean follow up was 5.1 years. The event-free survival rate was 80%, 78% and 73%, for the normal, 1-3 and >3 times by ULN groups respectively; log-rank p=0.0058. The event-free survival for the four CK-MB groups was 80%, 78%, 75% and 72% for the normal, 1-3 times, >3-5, and >5 times ULN groups respectively, log-rank p=0.0078. The CK-MB elevation following CABG remained a significant predictor following multivariate adjustment. With a point estimate of 1.04, 95% confidence limits 1.009-1.062, p=0.007. Conclusion Elevation of the isoenzyme CK-MB is an important predictor of long-term mortality following coronary bypass grafting. These data support routine use of creatinine kinase measurement following bypass surgery to further delineate long-term risk.
KW - Coronary artery bypass grafting
KW - Creatinine kinase
KW - Mortality
KW - Myocardial infarction
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U2 - 10.1016/S0195-668X(03)00234-3
DO - 10.1016/S0195-668X(03)00234-3
M3 - Article
C2 - 12871689
AN - SCOPUS:0041743801
SN - 0195-668X
VL - 24
SP - 1323
EP - 1328
JO - European heart journal
JF - European heart journal
IS - 14
ER -