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

• Published in: Journal of critical care Vol. 30; no. 6; pp. 1179 - 1183
• Main Authors: Bozbay, Mehmet, MD, Uyarel, Huseyin, MD, Avsar, Sahin, MD, Oz, Ahmet, MD, Keskin, Muhammed, MD, Tanik, Veysel Ozan, MD, Bakhshaliyev, Nijat, MD, Ugur, Murat, MD, Pehlivanoglu, Seckin, MD, Eren, Mehmet, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2015; Elsevier Limited
• Subjects: Aged; Biomarkers - blood; Blood pressure; Clinical; Clinical outcomes; Creatine Kinase - blood; Creatine Kinase, MB Form - blood; Creatinine - blood; Creatinine kinase–MB; Critical Care; Embolism; Female; Heart attacks; Hospital Mortality; Humans; Incidence; Male; Middle Aged; Mortality; Outcomes; Prognosis; Pulmonary; Pulmonary Embolism - blood; Risk Factors; Sensitivity and Specificity; Thrombolytic Therapy; Tissue Plasminogen Activator - metabolism; Veins & arteries; Germany; Clinical; Mortality; Creatinine kinase–MB; Pulmonary; Embolism; Outcomes
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2015.07.014

Abstract 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.