Correlation of Creatine Kinase Isoenzymes with Ventricular Remodeling After Non-ST-segment Elevation Myocardial Infarction
Objective:To investigate the correlation between human serum creatine kinase isoenzyme(CK-MB)levels within 24 h of onset and the degree of ventricular remodeling occurring after NSTEMI in patients with non-ST-segment elevation myocardial infarction(NSTEMI).Methods:110 NSTEMI patients diagnosed by clinical symptoms,18-lead electrocardiogram and blood biochemistry examination in the Laboratory Department admitted to the hospital from January 2017 to June 2020 were selected as the NSTEMI group,and another 110 patients with physical examination in the same period were selected as the control group.Clinical data were collected from all enrolled patients,and biochemical indices such as serum CK-MB,troponin I(cTnI),myoglobin(Mb),ultrasensitive C-reactive protein(hsCRP),and N-terminal B-type natriuretic peptide precursor(NT-proBNP)were tested in all enrolled patients.Left ventricular end-diastolic volume(LVEDV),end-diastolic epicardial volume(LVEDVepi),left ventricular end-diastolic internal diameter(LVEDD),and left ventricular ejection fraction(LVEF)were examined by cardiac ultrasonography for all enrollees within 4 d of admission and at the end of 12 months of follow-up.Results:Compared with the control group,the NSTEMI group had significantly higher levels of CK-MB,cTnI,Mb,hsCRP and NT-proBNP,increased LVEDV and LVEDD,and decreased LVEF,with statistically significant differences(t=5.177,7.350,11.310,23.150,5.375,4.359,3.698,4.037;P＜0.01).CK-MB was positively correlated with hsCRP,NT-proBNP,Mb,cTnI,LVEDV,and LVEDD(r=0.38,0.42,0.76,0.73,0.64,0.52;P＜0.01)and negatively correlated with LVEF and LVRI(r=-0.68,-0.61;P＜0.01).Ventricular remodeling at the end of 12 months of follow-up compared with 4 d after admission was characterized by a significant increase in LVEDV,LVEDD,and LVM,but the increase in LVEDV was predominant,but the LVEF and LVRI were significantly reduced,with statistically significant differences(t=4.624,3.953,3.755,4.112,4.132;P＜0.01).ROC curve analysis showed that the area under the curve for CK-MB was 0.72(95%CI 0.56 to 0.91),and the optimal threshold value for CK-MB was 248.5 μg/L,with a sensitivity of 85.9%and a specificity of 65.6%for the diagnosis of ventricular remodeling.Conclusion:Elevated serum CK-MB levels in patients with NSTEMI showed a significant and independent correlation with the degree of their ventricular remodeling,suggesting that serum CK-MB levels may be a valid predictor of the occurrence of ventricular remodeling in patients with NSTEMI.
NETL
NSTL
万方数据
维普
