Creatinine kinase isoenzyme-MB: A simple prognostic biomarker in patients with pulmonary embolism treated with thrombolytic therapy

Background: Creatinine kinase isoenzyme-MB(CK-MB) is a biomarker for detecting myocardial injury. The aim of this study was to evaluate the association between admission CK-MB levels and in-hospital and long-term clinical outcomes in pulmonary embolism(PE) patients treated with thrombolytic tissue-plasminogen activator. Methods: A total of 148 acute PE patients treated with tissue-plasminogen activator enrolled in the study. The study population was divided into 2 tertiles, based on admission CK-MB levels. The high CK-MB group (n = 35) was defined as having a CK-MB level in the third tertile (>31.5 U/L), and the low group (n = 113) was defined as having a level in the lower 2 tertiles (<= 31.5 U/L). Results: High CK-MB group had a higher incidence of in-hospital mortality (37.1% vs 1.7%, P<.001). Admission systolic blood pressure and tricuspid annular plane systolic excursion were lower in the high CK-MB group. In the receiver-operating characteristic curve analysis, a CK-MB value of more than 31.5 U/L yielded a sensitivity of 86.7% and specificity of 83.5% for predicting in-hospital mortality. During long-term follow-up, recurrent PE, major and minor bleeding, and mortality rates were similar in both groups. Conclusion: Creatinine kinase isoenzyme-MB is a simple, widely available, and useful biomarker for predicting adverse in-hospital clinical outcomes in PE. (C) 2015 Elsevier Inc. All rights reserved.