Biomarker Levels Post-CABG Strongly Linked to Mortality

February 8th, 2011

Biomarker Levels Post-CABG Strongly Linked to Mortality

Larry Husten, PHD

Creatine kinase (CK-MB) and troponin levels obtained in the first day after CABG are a strong predictor of long-term mortality, according to a new report appearing in JAMA. Michael Domanski and colleagues analyzed data from 7 studies that included 18,908 patients who underwent CABG and for whom data on biomarkers and mortality were available. Mortality was closely correlated with peak CK-MB levels: the 30-day death rate ranged from 0.63% for those with a CK-MB ratio below 1 to 7.06% for those with a CK-MB ratio over 20. In a multivariate model, CK-MB was the strongest predictor of mortality and persisted out to 1 year.

Here is the increase in relative risk by CK-MB category (relative to those with CK MB <1):

CK-MB ratio 1 to <5: 1.69 RR
CK-MB ratio 5 to <10: 2.98 RR
CK-MB ratio 10 to <20: 4.47 RR
CK-MB ratio 20 to <40: 8.73 RR
CK-MB ratio >40: 27.01 RR

“Although enzyme elevations are common following CABG surgery, our data make clear that the long-term prognosis is worse for patients who experience even a small elevation of CK-MB than those who do not experience such a increase,” the authors wrote.

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February 8th, 2011