Creatinine kinase isoenzyme-MB: A simple prognostic biomarker in patients with pulmonary embolism treated with thrombolytic therapy

J Crit Care. 2015 Dec;30(6):1179-83. doi: 10.1016/j.jcrc.2015.07.014. Epub 2015 Jul 18.


Background: Creatinine kinase isoenzyme-MB (CK-MB) is a biomarker for detecting myocardial injury. The aim of this study was to evaluate the association between admission CK-MB levels and in-hospital and long-term clinical outcomes in pulmonary embolism (PE) patients treated with thrombolytic tissue-plasminogen activator.

Methods: A total of 148 acute PE patients treated with tissue-plasminogen activator enrolled in the study. The study population was divided into 2 tertiles, based on admission CK-MB levels. The high CK-MB group (n=35) was defined as having a CK-MB level in the third tertile (>31.5 U/L), and the low group (n=113) was defined as having a level in the lower 2 tertiles (≤31.5 U/L).

Results: High CK-MB group had a higher incidence of in-hospital mortality (37.1% vs 1.7%, P<.001). Admission systolic blood pressure and tricuspid annular plane systolic excursion were lower in the high CK-MB group. In the receiver-operating characteristic curve analysis, a CK-MB value of more than 31.5 U/L yielded a sensitivity of 86.7% and specificity of 83.5% for predicting in-hospital mortality. During long-term follow-up, recurrent PE, major and minor bleeding, and mortality rates were similar in both groups.

Conclusion: Creatinine kinase isoenzyme-MB is a simple, widely available, and useful biomarker for predicting adverse in-hospital clinical outcomes in PE.

Keywords: Clinical; Creatinine kinase–MB; Embolism; Mortality; Outcomes; Pulmonary.

MeSH terms

  • Aged
  • Biomarkers / blood
  • Creatine Kinase / blood
  • Creatine Kinase, MB Form / blood*
  • Creatinine / blood
  • Female
  • Hospital Mortality
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prognosis
  • Pulmonary Embolism / blood*
  • Risk Factors
  • Sensitivity and Specificity
  • Thrombolytic Therapy*
  • Tissue Plasminogen Activator / metabolism


  • Biomarkers
  • Creatinine
  • Creatine Kinase
  • Creatine Kinase, MB Form
  • Tissue Plasminogen Activator