Predictive value of creatine kinase MB for contrast-induced acute kidney injury among myocardial infarction patients

Abstract

Background Predictive value of creatine kinase MB (CK-MB) for contrast-induced acute kidney injury (CI-AKI) among myocardial infarction (MI) patients has rarely been reported. We aim to evaluate the predictive value of CK-MB for CI-AKI among MI patients. Methods Totally, 1131 MI patients were included from the REduction of rIsk for Contrast-Induced Nephropathy (REICIN) study. The peak CK-MB before coronary angiography (CAG) was chosen. The study population was divided into two groups by log-transformed CK-MB cut-off point. The association between CK-MB and CI-AKI was tested by multivariable logistic regression. CK-MB was integrated with Age, creatinine and ejection fraction (ACEF) score and Mehran risk score (MRS) to evaluate the additive value of CK-MB. The integrated models were validated internally by the bootstrap method and externally by the PREdictive Value of COntrast voluMe to creatinine Clearance Ratio (PRECOMIN) study data set. Results Overall, 62(5.48%) patients developed CI-AKI, patients with CK-MB point > 4.7 displayed a higher incidence of CI-AKI than those without (11.9% vs. 4.0%, p < 0.001). CK-MB point > 4.7 was independently associated with CI-AKI (adjusted OR: 3.40, 95% CI: 1.93–5.98, p < 0.001). The additions of CK-MB to ACEF score, Mehran score A and Mehran score B resulted in increases in C-statistics, which ranged from 0.680 to 0.733 (p = 0.046), 0.694 to 0.727 (p = 0.091), 0.704 to 0.734 (p = 0.102), respectively. Internal validation also showed increases in C-statistics, and external validation performed well in discrimination and calibration. Conclusions Preprocedural peak CK-MB was a predictor of CI-AKI among MI patients.

From Classic to Modern Prognostic Biomarkers in Patients with Acute Myocardial Infarction

“…In addition, Hsu et al [ 51 ] proved that, in patients with AMI, early peak CK-MB levels (cut-off 48.2 ng/mL) were associated with an increased risk for adverse cardiac remodeling within six months after discharge. Additionally, patients with log-transformed CK-MB values greater than 4.7 had a 3.4-fold higher incidence of CIN than those without [ 102 ]. Peak CK-MB showed a strong association with chronic scar dimension and chronic wall motion abnormality index in patients with non-transmural myocardial infarction undergoing PCI or coronary artery bypass graft surgery (CABG) [ 103 ].…”

H2FPEF Score and Contrast-Induced Nephropathy in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

“…These findings are also consistent with previous research. 27,28 The H 2 FPEF score is used to diagnose HFpEF and for the differential diagnosis of cardiac and non-cardiac dyspnea. 9 With this scoring system, the diagnosis of HFpEF has become easier.…”

Clinical prognostic value of elevated CK-MB in severe multiple trauma patients with nonmyocardial contusion

“…In clinical practice, CK-MB plays an essential role in the diagnosis of acute coronary syndrome [8] . Moreover, an elevated serum level of CK-MB is associated with poor prognosis of COVID-19 [9,10] and provides a predictive value for contrast-induced acute kidney injury among myocardial infarction patients [11] . In addition, studies have also found that CK-MB is associated with the in-hospital mortality of polytrauma patients [4,12] .…”