关键词: 心肌梗死；肌酸激酶, MB型；冠状血管造影术；主要心血管不良事件； TIMI积分

Abstract: ObjectiveTo investigate the prediction value  of CKMB stratification in inhospital major adverse cardiovascular events (MACE) among patients with nonSTsegmentelevation myocardial infarction(NSTEMI)， whose diagnosis standard was determined by cardiac troponin I. MethodsThe study  enrolled consecutively NSTEMI patients diagnosed  by cardiac troponin I within  48 hours from the onset. According to CKMB level， the objects were divided into CKMB elevated group and CKMB normal group. CKMB elevated group was defined as the higher one in two CKMB detection results ( the time interval  of 6 to 12 hours ) was more than 16 U/L. Moreover， CKMB normal group was defined as the higher one was below 16 U/L. The value of TIMI scores and the modified TIMI ( MTIMI ) scores in prediction of inhospital MACE coronary artery angiography results and clinical indexes were compared between two groups. The MTIMI scores were defined as adding CKMB to the TIMI score and giving elevated CKMB level ( ≥16 U/L ) 1 point. ResultsCompared with CKMB normal group， the inflammatory indicators (white blood cells， neutrophilic granulocyte percentage， hsCRP)， renal function (blood urea nitrogen) were higher in  CKMB elevated group during hospitalization ( P<0.05). In addition， the criminal lesion in CKMB elevated group was more serious than the CKMB normal group (P<0.05). And the circumstance of heart function in CKMB elevated group was lower (P<0.05). Furthermore， the proportion of major adverse cardiovascular events (cardiac death、acute heart failure) was higher in elevated group (P<0.05). Meanwhile， the ROC curve analysis showed that， compared with TIMI scores， MTIMI scores was a better predictor of inhospital MACE in patients with NSTEMI. ConclusionNSTEMI patients with elevated CKMB had higher inhospital MACE rate. Moreover， after CKMB participating in the risk stratification score system， it is more accurate to assess risk stratification among patients with NSTEMI.

Key words: myocardial infarction；creatine kinase, MB form；coronary angiography；major adverse cardiovascular events, TIMI score