Elevated CK-MB levels are associated with adverse clinical outcomes in acute pancreatitis: a propensity score-matched study

Xiao-Ting Jiang; Ling Ding; Xin Huang; Yu-Peng Lei; Hua-Jing Ke; Hui-Fang Xiong; Ling-Yu Luo; Wen-Hua He; Liang Xia; Nong-Hua Lu; Yin Zhu

doi:10.3389/fmed.2023.1256804

Elevated CK-MB levels are associated with adverse clinical outcomes in acute pancreatitis: a propensity score-matched study

Front Med (Lausanne). 2023 Sep 8:10:1256804. doi: 10.3389/fmed.2023.1256804. eCollection 2023.

Authors

Xiao-Ting Jiang^#¹, Ling Ding^#¹, Xin Huang¹, Yu-Peng Lei¹, Hua-Jing Ke¹, Hui-Fang Xiong¹, Ling-Yu Luo¹, Wen-Hua He¹, Liang Xia¹, Nong-Hua Lu¹, Yin Zhu¹

Affiliation

¹ Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.

^# Contributed equally.

Abstract

Aim: Cardiac injury, reflected by the measured concentrations of chemicals released from injured cardiac muscle, is common in acute pancreatitis (AP). However, there is no adequate evidence assessing the impact of cardiac injury on AP-related outcomes. Creatine kinase-myocardial band (CK-MB) mainly exists in the myocardium. Therefore, we sought to evaluate the relationship between the increase in CK-MB and the adverse clinical outcomes of AP.

Methods: This propensity score-matched study analyzed AP patients admitted to the Department of Gastroenterology in the First Affiliated Hospital of Nanchang University from June 2017 to July 2022. Propensity score matching and multivariate logistic regression analysis were used to explore the relationship between CK-MB elevation and AP outcome variables.

Results: A total of 5,944 patients were screened for eligibility, of whom 4,802 were ultimately enrolled. Overall, 896 (18.66%) of AP patients had elevated (>24 U/ml) CK-MB levels, and 895 (99.89%) were paired with controls using propensity score matching. The propensity score-matched cohort analysis demonstrated that mortality (OR, 5.87; 95% CI, 3.89-8.84; P < 0.001), severe acute pancreatitis (SAP) (OR, 2.74; 95% CI, 2.23-3.35; P < 0.001), and infected necrotizing pancreatitis (INP) (OR, 3.40; 95% CI, 2.34-4.94; P < 0.001) were more frequent in the elevated CK-MB (>24 U/ml) group than in the normal CK-MB (≤ 24 U/ml) group. Using the multivariate logistic regression analysis, elevated CK-MB levels were independently associated with increased mortality (OR, 2.753, 95% CI, 2.095-3.617, P < 0.001), SAP incidence (OR, 2.223, CI, 1.870-2.643, P < 0.001), and INP incidence (OR, 1.913, 95% CI, 1.467-2.494, P < 0.001). CK-MB elevation was an independent risk factor for adverse clinical outcomes in AP patients.

Conclusion: CK-MB elevation was significantly related to adverse outcomes in AP patients, which makes it a potentially useful laboratory parameter for predicting adverse clinical outcomes of AP.

Keywords: acute pancreatitis; adverse clinical outcomes; cardiac injury; creatine kinase-myocardial band; propensity score-matching methods.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Double-Thousand Plan of Jiangxi Province (No. jxsq2019201028).