Creatine kinase-MB enzyme elevation following successful saphenous vein graft intervention is associated with late mortality

Circulation. 1999 Dec 14;100(24):2400-5. doi: 10.1161/01.cir.100.24.2400.


Background: Although the risk for development of creatine kinase (CK-MB) elevation after saphenous vein graft (SVG) intervention is high, its prognostic significance remains unknown. This study evaluated the impact of periprocedural CK-MB elevation on late clinical events following successful SVG angioplasty.

Methods and results: We studied 1056 consecutive patients with successful (defined by angiographic success and absence of major complications) intervention of 1693 SVG lesions. These patients were grouped as normal CK-MB (n=556), minor CK-MB rise (CK-MB 1 to 5 times normal, n=339), and major CK-MB rise (CK-MB >5 times normal, n=161). There were no differences in major clinical events at 30-day follow-up among the 3 groups. However, 1-year mortality was 4.8%, 6.5%, and 11. 7%, respectively, P<0.05 (ANOVA). Even within a population without any intraprocedure or in-hospital complications (n=727, 69% of the overall cohort), 1-year mortality remained significantly higher with CK-MB elevation: 2.4%, 5.5%, and 10.7%, respectively, P<0.05 (ANOVA). Multivariate analysis revealed major CK-MB elevation as the strongest independent predictor of late mortality (odds ratio 3.3, with 95% CI 1.7 to 6.2), followed by diabetes mellitus (odds ratio 2. 6, with 95% CI 1.5 to 4.5).

Conclusions: Major CK-MB elevation occurs after 15% of otherwise successful SVG interventions and is associated with increased late mortality.

MeSH terms

  • Aged
  • Cause of Death
  • Coronary Angiography
  • Coronary Disease* / enzymology
  • Coronary Disease* / mortality
  • Coronary Disease* / surgery
  • Creatine Kinase / metabolism*
  • Female
  • Humans
  • Inpatients / statistics & numerical data
  • Isoenzymes
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / enzymology
  • Myocardial Infarction / mortality
  • Myocardial Infarction / surgery
  • Predictive Value of Tests
  • Saphenous Vein / transplantation*
  • Stents
  • Treatment Outcome


  • Isoenzymes
  • Creatine Kinase