[en] To assess the prognostic significance of a low peak creatine kinase (CK) level, 723 consecutive patients admitted with acute myocardial infarction (AMI) within 16 hours after onset of symptoms were studied. Thrombolytic therapy was not attempted during the study. Patients were dichotomized according to their peak CK levels, determined from a cluster analysis of peak CK distribution among the population of patients who died within 3 years after hospital discharge. The 139 patients with low peak CK (less than or equal to 650 IU/liter) (group 1) were compared to the 584 patients with high peak CK (greater than 650 IU/liter) (group 2). Patients in group 1 were older and had a higher incidence of previous AMI, angina pectoris before AMI and non-Q-wave AMI. Despite a lower incidence of in-hospital complications and a nonsignificantly lower hospital mortality rate (4 vs 9%) the group 1 three-year posthospital mortality rate was higher (26 vs 17%; p less than 0.02), especially in the subgroup of patients with a Q-wave infarct (mortality 31% in group 1 vs 16% in group 2; p less than 0.001). Among the 491 patients who had a first Q-wave AMI, 55 had a peak CK less than or equal to 650 IU/liter. Compared to the 436 patients with a higher peak CK, these 55 patients had a higher incidence of early postinfarction angina (31 vs 14%; p less than 0.01), a similar hospital mortality (4 vs 7%) but a higher 3-year posthospital mortality (23 vs 12%; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Disciplines :
Cardiovascular & respiratory systems Laboratory medicine & medical technology
Author, co-author :
Pierard, Luc ; Centre Hospitalier Universitaire de Liège - CHU > Cardiologie
Dubois, Christophe ; Centre Hospitalier Universitaire de Liège - CHU > Cardiologie
Albert, Adelin ; Université de Liège - ULiège > Département des sciences de la santé publique > Informatique médicale et biostatistique
Chapelle, Jean-Paul ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale
Carlier, J.
Kulbertus, Henri ; Université de Liège - ULiège > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine)
Language :
English
Title :
Prognostic significance of a low peak serum creatine kinase level in acute myocardial infarction
Publication date :
1989
Journal title :
American Journal of Cardiology
ISSN :
0002-9149
eISSN :
1879-1913
Publisher :
Elsevier Science, New York, United States - New York
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