Relationship between creatine kinase and major bleeding in patients with non-ST-segment elevation acute coronary syndrome

Abstract

Objective: To investigate the relationship between creatine kinase (CK) and major bleeding in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients during hospitalization, and to analyze the predictive value of CK for major bleeding in NSTE-ACS patients during treatment. Methods: A total of 1469 NSTE-ACS patients admitted to our hospital from January 2017 to December 2019 were collected, including 1024 unstable angina pectoris patients and 445 non-ST-segment elevation myocardial infarction patients. Plasma CK and hemoglobin concentrations were measured after admission. The patients were divided into major bleeding group (n=31) and non-major bleeding group (n=1438) according to Thrombolysis In Myocardial Ischemia bleeding classification standard, and they were given routine treatment. Results: During the treatment period, major bleeding occurred in 31 of 1469 NSTE-ACS patients, accounting for 2.11%. CK value in major bleeding group was higher than that in non-major bleeding group (P<0.001). According to the quartile, CK was divided into groups Q1-Q4, and the incidence of major bleeding in group Q4 was higher than that of the other three groups (P<0.001). Plasma CK was positively correlated with major bleeding in NSTE-ACS patients (r=0.59, P<0.001). Receiver operating characteristic curve analysis showed that the area under the curve of baseline CK value was 0.793 (SE=0.062, P=0.001, 95％CI 0.711-0.872) in NSTE-ACS patients during treatment. Conclusion: CK was associated with major bleeding in NSTE-ACS patients.