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Value of CKMB stratification in prediction of inhospital major adverse cardiovascular #br# events among patients with nonSTsegmentelevation myocardial infarction#br#

  

  1. Department of  Cardiology,the Second Hospital of Tianjin Medical University, Tianjin 300211, China
  • Online:2017-01-05 Published:2017-01-12
  • Contact: Corresponding author: Che Jingjin,Email: jingjinche@aliyun.com

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