Enzyme level linked to death after angioplasty

that if the CK-MB elevation is less than five times the upper limits of normal, particularly if the rise is not associated with any other risk factors, then it is quite safe to discharge the patient in the usual fashion, which is the day after the procedure," he says.

"In addition, patients who have higher than five times normal CK-MB levels should probably only be considered for longer hospital stays if they are in a high-risk group," says Ellis. "These patients should also be strongly considered for statin therapy."

Investigators evaluated data on 8,409 patients (average age 65) who had successful catheterization procedures and didn't have heart attacks or require emergency surgery. CK-MB was routinely measured six to eight hours after angioplasty and the morning after angioplasty. About 17 percent of the patients (1,446) had CK-MB levels above normal after their procedures, and they were separated into two groups according to their CK-MB levels: one to five times the upper limit of normal or greater than five times the upper limit of normal.

Ellis and his associates found that no patient with CK-MB levels elevated less than five times normal died during the first week after catheterization. Most of the early deaths occurred during the first three to four months after the procedures. Patients whose CK-MB levels exceeded five times the upper limit had a mortality risk of 8.9 percent at four months. This was significantly greater than the 1.9 percent risk for patients who had CK-MB levels one to five times the upper limit, and the 1.2 percent for patients who had normal CK-MB levels.

The investigators compared patients who had CK-MB elevation after a catheter procedure and who died within four months to other groups of patients with and without elevated CK-MB. They identified several factors associated with an increased risk of early death: incomplete restoration of blood flow through a blocked vessel, heart failure, older age, i

Contact: Carole Bullock
American Heart Association

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