Impact of Consistent and Inconsistent Creatine Kinase-MB and Troponin Levels on Hospital lethality in Acute Coronary Disorder

Creatine Kinase-MB and Troponin as Mortality Predictors

Authors

  • Syed Wajeeh Ur Rehman Shah International Medical University, Kyrgyzstan, Bishkek, Kyrgyzstan Author
  • Hira Shehzadi Hainan Medical University, Haikou, China Author
  • Neelam Shahzadi Karachi Institute of Medical Sciences(KIMS),Karachi, Pakistan Author
  • Zainab khalid University College of Medicine and Dentistry(UCMD), Lahore, Pakistan Author
  • Muhammad Naeem University College of Medicine and Dentistry(UCMD), Lahore, Pakistan Author
  • Raman Latif Qureshi Fatima Jinnah Medical University,Lahore, Pakistan Author
  • Mubeen Fatima Department of Forensic Sciences , Lahore University of Biological & Applied Sciences (UBAS), Lahore, Pakistan Author

DOI:

https://doi.org/10.69750/dmls.01.07.055

Keywords:

Myocardial Infarction, Prognosis., Creatine Kinase, MB Form, Troponin, Acute Coronary Syndrome, Biomarkers, Hospital Mortality, Logistic Models.

Abstract

Background: Serum CK-MB and cardiac troponin are important diagnostic predictors used to determine the prognosis of patients with acute coronary disorders (ACD). However, the effects of these biomarkers on hospital lethality remain underexplored.

Objective: This research aimed to determine the effects of consistent and inconsistent CK-MB and troponin levels on hospital mortality in ACD patients.

Methodology: This comparative study was conducted on patients with confirmed ACD admitted to a tertiary care hospital from January 2023 till June 2024. Patients were categorized into two groups based on the consistency of their CK-MB and troponin levels during hospitalization: consistently elevated or normal biomarkers versus those with variable levels. Hospital lethality was defined as mortality occurring during the hospital stay. SPSS version 26 was used for statistical analysis. The study utilized multivariate logistic regression to ascertain independent factors that are associated with hospital death. For continuous variables, t-tests or Mann-Whitney U tests were employed, and for categorical data, chi-square tests.

Results: There were 500 patients in the trial; 250 were in the inconsistent group and 250 were in the consistent group. In the inconsistent group, the hospital fatality rate was 18%, while in the consistent group it was 10% (p < 0.05). Variability in biomarker levels was an independent predictor of higher hospital mortality, according to multivariate analysis (OR 2.5, 95% CI 1.5–4.2).

Conclusion: Inconsistent CK-MB and troponin levels were associated with higher hospital mortality in ACD patients. Monitoring and stabilizing these biomarkers may be essential for improving patient outcomes and guiding therapeutic interventions in acute care settings.

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References

Zhou B, She J, Wang Y, Ma X. The clinical characteristics of myocardial injury in severe and very severe patients with 2019 novel coronavirus disease. J Infect. 2020;81(1):147-78.doi: 10.1016/j.jinf.2020.03.021

Al-Khafaji DKH, Al-Quzwiny KYH, Al-Daami QJ. Analytical Implication of Cardiac Biomarkers in Patients with Acute Ischemic Stroke: A Cross-Section Study. Jour Med Resh and Health Sci. 2022;5(8):2145-52.doi: 10.52845/JMRHS/2022-5-8-3

Sandoval Y, Apple FS, Saenger AK, Collinson PO, Wu AHB, Jaffe AS. 99th Percentile Upper-Reference Limit of Cardiac Troponin and the Diagnosis of Acute Myocardial Infarction. Clinical Chemistry. 2020;66(9):1167-80.doi: 10.1093/clinchem/hvaa158

Pang X, Ge M. Effect of geographical factors on reference values of creatine kinase isoenzyme. International Journal of Biometeorology. 2023;67(4):553-63.doi: 10.1007/s00484-023-02429-z

Sheibani M, Mirfallah Nassiri AA, Abedtash A, McDonald R, Zamani N, Hassanian‐Moghaddam H. Troponin, A Predictor of Mortality in Methadone Exposure: An Observational Prospective Study. Journal of the American Heart Association. 2021;10(8):e018899.doi: doi:10.1161/JAHA.120.018899

Schmitz T, Wein B, Methe H, Linseisen J, Heier M, Peters A, et al. Association between admission ECG changes and long-term mortality in patients with an incidental myocardial infarction: Results from the KORA myocardial infarction registry. European Journal of Internal Medicine. 2022;100:69-76.doi:10.1016/j.ejim.2022.03.009

Giannitsis E, Blankenberg S, Christenson RH, Frey N, von Haehling S, Hamm CW, et al. Critical appraisal of the 2020 ESC guideline recommendations on diagnosis and risk assessment in patients with suspected non-ST-segment elevation acute coronary syndrome. Clinical Research in Cardiology. 2021;110(9):1353-68.doi: 10.1007/s00392-021-01821-2

Flores Solís LM, Flores-Solís LM, Hernández Domínguez JL, Hernández-Domínguez JL, Otero González A, Otero-González A, et al. Cardiac troponin I and creatine kinase MB isoenzyme in patients with chronic renal failure. Nefrología (English Edition). 2012;32(6):809-18.doi: 10.3265/Nefrologia.pre2012.Jul.10986

Danese E, Montagnana M. An historical approach to the diagnostic biomarkers of acute coronary syndrome. Annals of Translational Medicine. 2016;4(10):194.doi: 10.21037/atm.2016.05.19

McErlean E, Deluca S, Lente F, Peacock W, Rao JS, Balog C, et al. Comparison of troponin T versus creatine kinase-MB in suspected acute coronary syndromes. The American journal of cardiology. 2000;85:421-6.doi: 10.1016/S0002-9149(99)00766-3

Pelletier R, Choi J, Winters N, Eisenberg MJ, Bacon SL, Cox J, et al. Sex Differences in Clinical Outcomes After Premature Acute Coronary Syndrome. Canadian Journal of Cardiology. 2016;32(12):1447-53.doi: 10.1016/j.cjca.2016.05.018

Miki T, Itoh T, Sunaga D, Miura T. Effects of diabetes on myocardial infarct size and cardioprotection by preconditioning and postconditioning. Cardiovascular Diabetology. 2012;11(1):67.doi: 10.1186/1475-2840-11-67

Sławiński G, Wrona A, Dąbrowska-Kugacka A, Raczak G, Lewicka E. Immune Checkpoint Inhibitors and Cardiac Toxicity in Patients Treated for Non-Small Lung Cancer: A Review. International Journal of Molecular Sciences [Internet]. 2020; 21(19).doi: 10.3390/ijms211971 95

Amoras TSG, Mendonça TS, Melo GS, Pereira KRP, Zaninotto CV, de Oliveira SS, et al. Sociodemographic and clinical variables as determinants of mortality and survival in patients with acute ST-elevation myocardial infarction in the Eastern Amazon. Journal of Public Health Research. 2023;12(1):22799036221150062.doi: 10.1177/22799036221150062

Karimian M, Jamshidbeigi A, Badfar G, Azami M. Laboratory findings in coronavirus disease 2019 (COVID-19) patients: a comprehensive systematic review and meta-analysis. medRxiv. 2020:2020.06.07.20124602.doi: 10.1101/2020.06.07.20124602

Raffee LA, Alawneh KZ, Ababneh MJ, Hijazi HH, Al abdi RM, Aboozour MM, et al. Clinical and electrocardiogram presentations of patients with high serum potassium concentrations within emergency settings: a prospective study. International Journal of Emergency Medicine. 2022;15(1):23.doi: 10.1186/s12245-022-00422-8

Hu F, Yu H, Zong J, Xue J, Wen Z, Chen M, et al. The impact of hypertension for metabolites in patients with acute coronary syndrome. Ann Transl Med. 2023;11(2):50.doi: 10.21037/atm-22-6409

Aa N, Lu Y, Yu M, Tang H, Lu Z, Sun R, et al. Plasma Metabolites Alert Patients With Chest Pain to Occurrence of Myocardial Infarction. Frontiers in Cardiovascular Medicine. 2021;8.doi: 10.3389/fcvm.2021.652746

Peng Y, Chen Z, Luo Z, Luo G, Chu Y, Zhou B, et al. Identifying prognostic factors for pulmonary embolism patients with hemodynamic decompensation admitted to the intensive care unit. Medicine. 2024;103(3).doi: 10.1097/MD.0000000000036392

Momtazmanesh S, Shobeiri P, Hanaei S, Mahmoud-Elsayed H, Dalvi B, Malakan Rad E. Cardiovascular disease in COVID-19: a systematic review and meta-analysis of 10,898 patients and proposal of a triage risk stratification tool. The Egyptian Heart Journal. 2020;72(1):41.doi: 10.1186/s43044-020-00075-z

Moady G, Rubinstein G, Mobarki L, Atar S. Takotsubo Syndrome in the Emergency Room — Diagnostic Challenges and Suggested Algorithm. RCM. 2022;23(4).doi: 10.31083/j.rcm2304131

Huang W, Frederich A, Putri AR. Effects of Remote Ischaemic Conditioning in Stable and Unstable Angina Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis. Heart, Lung and Circulation. 2024;33(4):406-19.doi: 10.1016/j.hlc.2024.01.023

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Published

02-10-2024

How to Cite

Shah, S. W. U. R. ., Shehzadi, H. ., Shahzadi, N., khalid, Z. ., Naeem, M. ., Qureshi, R. L. ., & Fatima, M. (2024). Impact of Consistent and Inconsistent Creatine Kinase-MB and Troponin Levels on Hospital lethality in Acute Coronary Disorder: Creatine Kinase-MB and Troponin as Mortality Predictors. DEVELOPMENTAL MEDICO-LIFE-SCIENCES, 1(7), 12-19. https://doi.org/10.69750/dmls.01.07.055

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