The Prognostic Value of CK-MB in Acute Myocardial Infarction in Developing Countries: A Descriptive Study

Abstract

Background: Acute myocardial infarction is a common condition among developing countries with access-tocare issues. However, scarce information is available on the association between prognostic markers and patient outcomes in areas around the globe with scarcere sources. Aim: To evaluate the association between creatine phosphokinase myocardial band (CK-MB) and outcomes measured up to six months after the infarction. Methods: This is a longitudinal cohort study evaluating patients with a diagnosis of myocardial infarction up to six months after the ischemic event. Patients underwent catheterization up to 12 hours after the first symptoms. The primary predicting variable was CK-MB level, with outcome variables including re-infarction, death, and functional level status at 30 days and 6 months after infarction. Results: The average time of arrival was seven hours after the start of pain. When combining all adverse outcomes, 13.7% presented with either a myocardial re-infarction or death. When evaluating the association between serial CK-MB measurements and various outcomes of interest, there was usually no significant association with re-infarction, death or functional class at the 30-day and six-month follow-up evaluations. However, increased CK-MB measurements at admission, 18 and 72 hours continued to be significantly associated with increased length of hospital stay after adjusting for age and gender. CK-MB levels greater than 124 mg/dl after 18 hours after first symptoms were significant predictors of all combined adverse outcomes. Conclusion: CK-MB represents an alternative when it comes to prognostic predictors of combined outcomes including myocardial re-infarction, re-intervention or death.