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Increased mortality after coronary artery bypass graft surgery is associated with increased levels of postoperative creatine kinase-myocardial band isoenzyme release

Results from the GUARDIAN trial

Karen Klatte, MD^*, Bernard R. Chaitman, MD, FACC^*,2, Pierre Theroux, MD, FACC^,2, Jeffrey A. Gavard, PhD^*, Karen Stocke, MBA^*, Steven Boyce, MD, FACC^,2, Claus Bartels, MD^,2, Birgit Keller, MS^||,2, Andreas Jessel, MD^||,2 for the GUARDIAN Investigators¹

^* St. Louis University Health Sciences Center, St. Louis, Missouri, USA
Montreal Heart Institute, Montreal, Quebec, Canada
Washington Heart Center, Washington, DC, USA
Med. Universitatsklinik, Herzchirurgische Klinik, Luebeck, Germany
^|| Aventis Pharmaceuticals, Inc., Bridgewater, New Jersey, USA

View larger version (22K): [in a new window]   Figure 1 Cumulative six-month survival rates according to the peak creatine kinase-myocardial band ratio category (p < 0.0001). All pairwise comparisons between the categories were significant, except for the 5 and <10 upper limits of normal (ULN) group versus the 10 and <20 ULN group (p = 0.26). CABG = coronary artery bypass graft surgery.

View larger version (20K): [in a new window]   Figure 2 Cumulative six-month survival rates according to the peak creatine kinase-myocardial band value category (p < 0.0001). All pairwise comparisons between the categories were significant, except for the 60 U/l group versus the >60 and 100 U/l group (p = 0.09). CABG = coronary artery bypass graft surgery.

View larger version (17K): [in a new window]   Figure 3 Receiver operating characteristic curve predicting six-month mortality at various levels of peak creatine kinase-myocardial band (CK-MB) enzyme ratios. ULN = upper limits of normal.