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Clinical outcomes after detection of elevated cardiac enzymes in patients undergoing percutaneous intervention

Barbara E. Tardiff, MD^a, Robert M. Califf, MD, FACC^a, James E. Tcheng, MD, FACC^a, A. Michael Lincoff, MD, FACC^*, Kristina N. Sigmon, MA^a, Robert A. Harrington, MD, FACC^a, Kenneth W. Mahaffey, MD^a, E. Magnus Ohman, MD, FACC^a, Paul S. Teirstein, MD, FACC, James C. Blankenship, MD, FACC, Michael M. Kitt, MD, Eric J. Topol, MD, FACC^* for the IMPACT-II Investigators

^a Duke Clinical Research Institute, Durham, North Carolina, USA
^* the Cleveland Clinic Foundation, Cleveland, Ohio, USA
Scripps Clinic, La Jolla, California, USA
Geisinger Medical Center, Danville, Pennsylvania, USA
COR Therapeutics, South San Francisco, California, USA

View larger version (22K): [in a new window]   Figure 1 Point estimates and 95% confidence intervals for frequency of later clinical events at 30 days, by postintervention CK stratum (from left to right): 0–1 times normal, 1–3 times normal, 3–5 times normal, 5–10 times normal, or >10 times normal. MI = myocardial infarction; CABG = coronary artery bypass graft; PTCA = percutaneous transluminal coronary angioplasty.

View larger version (21K): [in a new window]   Figure 2 Point estimates and 95% confidence intervals for frequency of later clinical events at 30 days, by postintervention CK-MB stratum (from left to right): 0–1 times normal, 1–3 times normal, 3–5 times normal, 5–10 times normal, or >10 times normal. Abbreviations as in Figure 1.

View larger version (20K): [in a new window]   Figure 3 Point estimates and 95% confidence intervals for frequency of later clinical events at 6 months, by postintervention CK stratum (from left to right): 0–1 times normal, 1–3 times normal, 3–5 times normal, 5–10 times normal, or >10 times normal. Abbreviations as in Figure 1.

View larger version (21K): [in a new window]   Figure 4 Point estimates and 95% confidence intervals for frequency of later clinical events at 6 months, by postintervention CK-MB stratum (from left to right): 0–1 times normal, 1–3 times normal, 3–5 times normal, 5–10 times normal, or >10 times normal. Abbreviations as in Figure 1.

View larger version (13K): [in a new window]   Figure 5 Kaplan-Meier curves illustrating the incidence of occurrence of death and later infarction at 30 days in patients with postprocedural CK-MB elevation 0–1 times normal (heavy solid line), 1–3 times normal (light solid line), 3–5 times normal (heavy short dashes), 5–10 times normal (light short dashes), or >10 times normal (long dashes).

View larger version (15K): [in a new window]   Figure 6 Kaplan-Meier curves illustrating the incidence of occurrence of death and later infarction at 6 months in patients with postprocedural CK-MB elevation 0–1 times normal (heavy solid line), 1–3 times normal (light solid line), 3–5 times normal (heavy short dashes), 5–10 times normal (light short dashes), or >10 times normal (long dashes).

View larger version (17K): [in a new window]   Figure 7 Probability of the 6-month composite of death and infarction as a function of CK-MB elevation. ULN = upper limit of normal.