Using data from the Platelet Glycoprotein IIb/IIIa in Unstable Angina:
Receptor Suppression Using Integrilin Therapy (PURSUIT) trial, Alexander and
colleagues found that in patients with acute coronary syndromes without ST-segment
elevation, peak levels of the myocardium-specific creatine-kinase isoenzyme
(CK-MB) during hospitalization were predictive of 30-day and 6-month mortality.
Thirty-day and 6-month mortality rates associated with normal peak CK-MB levels
were 1.8% and 4.0%; for peak CK-MB levels 1 to 2 times normal, 3.3% and 6.2%;
for levels 3 to 5 times normal, 5.1% and 7.5%; and for peak CK-MB levels greater
than 10 times normal, 8.3% and 11%. Thirty-day mortality risk increased in
a stepwise fashion with increasing peak CK-MB level.