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 2022 till June 2023. 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.

Downloads

Download data is not yet available.

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. J Med Res 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. Clin Chem. 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. Int J Biometeorol. 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 as a predictor of mortality in methadone exposure: an observational prospective study. J Am Heart Assoc. 2021;10(8):e018899. 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 incidental myocardial infarction. Eur J Intern Med. 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. Appraisal of the 2020 ESC guideline recommendations for suspected NSTE-ACS. Clin Res Cardiol. 2021;110(9):1353-68. doi:10.1007/s00392-021-01821-2

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

Danese E, Montagnana M. Historical approach to biomarkers of acute coronary syndrome. Ann Transl Med. 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. Troponin T vs CK-MB in suspected ACS. Am J Cardiol. 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 outcomes after premature ACS. Can J Cardiol. 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. Cardiovasc Diabetol. 2012;11:67. doi:10.1186/1475-2840-11-67

Sławiński G, Wrona A, Dąbrowska-Kugacka A, Raczak G, Lewicka E. Immune checkpoint inhibitors and cardiac toxicity. Int J Mol Sci. 2020;21(19):7195. doi:10.3390/ijms21197195

Amoras TSG, Mendonça TS, Melo GS, Pereira KRP, Zaninotto CV, de Oliveira SS, et al. Predictors of mortality in STEMI patients in the Eastern Amazon. J Public Health Res. 2023;12(1):22799036221150062. doi:10.1177/22799036221150062

Karimian M, Jamshidbeigi A, Badfar G, Azami M. Laboratory findings in COVID-19: 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. ECG and clinical presentations in patients with hyperkalemia. Int J Emerg Med. 2022;15:23. doi:10.1186/s12245-022-00422-8

Hu F, Yu H, Zong J, Xue J, Wen Z, Chen M, et al. Impact of hypertension on metabolites in ACS. 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 to alert chest-pain patients for MI. Front Cardiovasc Med. 2021;8:652746. doi:10.3389/fcvm.2021.652746

Peng Y, Chen Z, Luo Z, Luo G, Chu Y, Zhou B, et al. Prognostic factors for pulmonary embolism with hemodynamic decompensation. Medicine (Baltimore). 2024;103(3):e36392. doi:10.1097/MD.0000000000036392

Momtazmanesh S, Shobeiri P, Hanaei S, Mahmoud-Elsayed H, Dalvi B, Malakan Rad E. Cardiovascular disease in COVID-19: systematic review. Egypt Heart J. 2020;72:41. doi:10.1186/s43044-020-00075-z

Moady G, Rubinstein G, Mobarki L, Atar S. Takotsubo syndrome in ER—diagnostic challenges. Rev Cardiovasc Med. 2022;23(4):131. doi:10.31083/j.rcm2304131

Huang W, Frederich A, Putri AR. Remote ischaemic conditioning in PCI: systematic review. Heart Lung Circ. 2024;33(4):406-19. doi:10.1016/j.hlc.2024.01.023

Downloads

Crossmark - Check for Updates PlumX Metrics

Published

30-09-2024

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), 8-13. https://doi.org/10.69750/dmls.01.07.055

Share