Elevation of creatine kinase, MB fraction after elective coronary intervention: a valid surrogate end point of poor late outcome?

● Release of CK-MB is common if sought for in up to 25% of cases of percutaneous intervention; most commonly ,5 times the upper limit of normal. ● The causes may include angiographically evident events, such as branch vessel occlusion or embolization, but just as often they may be neither symptomatic or angiographically apparent. ● The likelihood of enzyme release is greater with nonballoon devices, such as rotablator, directional atherectomy and stents. ● Enzyme release is correlated with late mortality in some studies. ● The exact level of enzyme elevation to diagnose “myocardial infarction” with its attendant clinical and economic implications for patient management is uncertain, although an upper level of three times normal has been suggested (1).