Long-Term Prognostic Value of CK-MB and the Troponins after Angioplasty in Patients with Stable Angina

Figures & data

Table I. Patient characteristics of all patients as well as the comparison of controls vs. high biomarker groups (presented as p-values in the biomarker columns).

	All patients CK-MB^1 TnT^2 TnI^3
Characteristic	N = 202
Age in years (range)	65.8 (41–85)	65.6 vs. 68.6	65.7 vs. 67.2	65.4 vs. 68.0
Males (%)	165 (84)	157 vs. 8*	151 vs. 14	143 vs. 22**
EF^1 % (95% CI)^4	64.2 (62.5, 65.9)	64.1 vs. 66.4	64.1 vs. 65.4	63.8 vs. 66.3
Body mass index (weight/height^2)	(26.0, 27.0)	26.6 vs. 25.4	26.7 vs. 25.5	26.7 vs. 25.7
Ever smokers	146 (72)	138 vs. 8	133 vs. 13	129 vs. 17**
Current smokers	65 (32)	61 vs. 4	57 vs. 8	56 vs. 9
Hypercholesterolemia^5	173 (86)	161 vs. 12	155 vs. 18	145 vs. 28
Diabetes mellitus	19 (9)	19 vs. 0	18 vs. 1	17 vs. 2
Hypertension	70 (35)	63 vs. 7	63 vs. 7	56 vs. 14
Current use of acetylsalicylic acid	196 (98)	182 vs. 14	176 vs. 20	163 vs. 33
B-blocker	163 (87)	152 vs. 11	147 vs. 16	138 vs. 25
Prior myocardial infarction	83 (41)	79 vs. 4	75 vs. 8	72 vs. 11
- Anterior	38 (19)	38 vs. 0	35 vs. 3	35 vs. 3
- Inferior	44 (22)	40 vs. 4	39 vs. 5	36 vs. 8
NYHA class
0–1	26 (13)	25 vs. 1	21 vs. 5	21 vs. 5
2	132 (65)	123 vs. 9	121 vs. 11	113 vs. 19
3	44 (22)	40 vs. 4	39 vs. 5	34 vs. 10
Prior bypass surgery	28 (14)	28 vs. 0	27 vs. 1	25 vs. 3
Prior coronary angioplasty	37 (18)	35 vs. 2	34 vs. 3	31 vs. 6
Creatinine (mmol/l, range)	96.8 (57–154)	97.4 vs. 89.5	97.3 vs. 93.0	98.2 vs. 90.0**
Systolic blood pressure (mmHg)	137.5	137.1 vs. 142.9	137.7 vs. 135.1	137.5 vs. 137.1
Diastolic blood pressure (mmHg)	80.8	80.9 vs. 80.1	81.2 vs. 77.9	81.2 vs. 78.9
In hospital stay in days (range)	1.7 (0–22)	1.6 vs. 2.4	1.6 vs. 2.1	1.6 vs. 1.9

¹CK-MB < 15 μg/l (n = 188) vs. CK-MB ≥ 15 μg/l (n = 14); ²TnT < 0.36 μg/l (n = 181) vs. TnT ≥ 0.36 μg/l (n = 21); ³TnI < 0.15 μg/l (n = 168) vs. TnI ≥ 0.15 (n = 34); ⁴Angiography; ⁵Treated hypercholesterolemia or cholesterol ≥ 6.5mmol/l in untreated patients; CAD, coronary artery disease; *2-sided p-value < 0.05; **2-sided p-value < 0.001.

Table II. Procedural data of all patients as well as the comparison of controls vs. high biomarker groups.

	All patients CK-MB^1 TnT^2 TnI^3
Characteristic	N = 202
Site of stenosis treated^1
- LMS (unprotected)	0
- LAD	117 (58)	109 vs. 8	105 vs. 12	96 vs. 21
- Cx/Marginal	108 (54)	100 vs. 8	95 vs. 13	86 vs. 22
- RCA	84 (42)	113 vs. 9	113 vs. 9	104 vs. 18
Coronary artery disease^4
1-vessel	83 (41)	79 vs. 4	74 vs. 9	70 vs. 13
2-vesssel	73 (38)	66 vs. 7	65 vs. 8	60 vs. 13
3-vessel	45 (22)	43 vs. 2	42 vs. 3	38 vs. 7
Type of lesion
- proximal LAD	39 (19)	35 vs. 4	34 vs. 5	33 vs. 6
- ostial	8 (4)	8 vs. 0	6 vs. 2	7 vs. 1
- occlusion	49 (24)	48 vs. 1	46 vs. 3	41 vs. 8
- bifurcation	27 (13)	24 vs. 3	25 vs. 2	21 vs. 6
- long lesion (> 20 mm)	14 (7)	12 vs. 2	11 vs. 3	11 vs. 3
- SVG	11 (5)	11 vs. 0	9 vs. 2	9 vs. 2
Fraction with stents implanted	160 (79)	147 vs. 13	141 vs. 19	131 vs. 29
Mean stent diameter in mm (range)	3.0 (2.5–4.0)	3.0 vs. 3.0	3.0 vs. 3.0	3.0 vs. 2.9
Mean stent length in mm (range)	16.5 (8–32)	16.3 vs. 16.9	16.5 vs. 15.8	16.4 vs. 16.3
Stents per procedure (range)	1.5 (1 – 5)	1.4 vs. 2.1*	1.4 vs. 1.8	1.4 vs. 1.8*
Glycoprotein IIb/IIIa inhibitor	29 (14)	27 vs. 2	25 vs. 4	25 vs. 4
Restenosis	25 (12)	22 vs. 3	22 vs. 3	23 vs. 2
Reintervention (PCI or CABG)	66 (33)	60 vs. 6	58 vs. 8	55 vs. 11
Complications	41 (21)	35 vs. 6*	33 vs. 8*	30 vs. 11

¹CK-MB < 15 μg/l (n = 188) vs. CK-MB ≥ 15 μg/l (n = 14); ²TnT < 0.36 μg/l (n = 181) vs. TnT ≥ 0.36 μg/l (n = 21); ³TnI < 0.15 μg/l (n = 168) vs. TnI ≥ 0.15 (n = 34); ⁴> 50% stenosis by Angiography; *2-sided p-value < 0.05.

Table III. Temporal pattern of the cardiac biomarkers before and after angioplasty.

N = 202	Before	1 – 3 hours	4 – 8 hours	16 – 20 hours	% high values^1
CKMB (reference value < 5 μg/l)	1.5 (1.0)	1.7 (2.7)	3.2 (5.1)	4.8 (11.0)	6.9
TnT (reference value < 0.12 μg/l)	0.09 (0.04)	0.11 (0.09)	0.11 (0.10)	0.19 (0.38)	10.4
TnI (reference value < 0.05 μg/l)	0.03 (0.02)	0.06 (0.23)	0.09 (0.16)	0.16 (0.35)	16.8

Values are mean (SD); ¹Peak values ≥ 3 times the reference level.

Figure 1. Kaplan-Meier plot of event-free survival (all patients, n = 202). P-value = 0.05 (log-rank test).

Figure 2. Kaplan-Meier plot of event-free survival (all patients, n = 202). P-value = 0.22 (log-rank test).

Figure 3. Kaplan-Meier plot of event-free survival (all patients, n = 202). P-value = 0.34 (log-rank test)