Creatine-kinase and dialysis patients, a helpful tool for stratifying cardiovascular risk?

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• 作者：Borja Quiroga ; ^{borjaqg@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Almudena Vega ; Soraya Abad ; Maite Villaverde ; Javier Reque ; Juan Manuel Ló ; pez-Gó ; mez
• 关键词：Cardiac biomarkers ; Cardiovascular ; CKMB ; Hemodialysis
• 刊名：Nefrología
• 出版年：2016
• 出版时间：January-February 2016
• 年：2016
• 卷：36
• 期：1
• 页码：51-56
• 全文大小：288 K

文摘

Hemodialysis patients have an enhanced risk for cardiovascular events. Cardiac biomarkers provide useful information for stratifying their risk. However the prognosis value of creatine kinase MB isoenzyme (CKMB) has not yet been validated in this population. The aim of the present study is to determine the predictable value of CK-MB in hemodialysis.

Methods

A cohort of 211 hemodialysis patients (58.3% male, median age 73 (60–80) years) were followed for 39 (19–56) months. Cardiac biomarkers including CKMB were recorded at baseline. Factors associated to CKMB and prognosis value of this biomarker was studied.

Results

The median value of CKMB was 1 (1–2) ng/mL with no patient exceeding normal laboratory values. Previous heart disease, diabetes mellitus, peripheral vascular disease and systolic and diastolic dysfunction were associated with higher levels of CKMB. Ninety-four patients (44.5%) cardiovascular events were recorded. CKMB levels ≥2 ng/mL was independently associated to cardiovascular events during the follow up after adjusting. Adding CKMB to a model including several variables for predicting cardiovascular events, resulted in 17% improvement in risk discrimination (IDI) with a relative IDI of 9.9% (p = 0.04).

Conclusions

CKMB is a good marker for stratifying cardiovascular risk in hemodialysis patients and adds prognosis information to other well known independent predictors for cardiovascular events.