Xin Yijing, Lyu Siqi, Yang Yanmin
Emergency Center, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037 Beijing, China.
Int J Cardiol Heart Vasc. 2024 Nov 23;56:101566. doi: 10.1016/j.ijcha.2024.101566. eCollection 2025 Feb.
The aim of this study was to evaluate the association between baseline creatine kinase-myocardial band (CK-MB) and the risk of in-hospital all-cause mortality in acute type A and type B aortic dissection (AD) patients, and to explore the predictive value of CK-MB.
A single-center retrospective analysis was performed on 552 acute AD (type A 329 patients, type B 223 patients). Outcomes were the incidence of in-hospital all-cause mortality. Kaplan-Meier curve was used to compare the all-cause death risk in two groups (normal CK-MB group and elevated CK-MB group). The Cox regression model and restricted cubic splines (RCS) were conducted to assess the relationship between CK-MB and outcomes. Stratified analysis was performed based on gender, age (<50 years or ≥ 50 years), and surgery or endovascular therapy.
The Kaplan-Meier curves showed statistically significant differences in outcomes among the different CK-MB level groups for both acute type A and type B AD patients. Cox regression analysis revealed that the in-hospital mortality risk was significantly high in the elevated CK-MB groups for both acute type A and type B AD patients. The RCS curve revealed that CK-MB was non-linearly and J-shaped correlated with in-hospital all-cause mortality for acute type A AD patients, and linearly correlated with in-hospital all-cause mortality for acute type B AD patients.
Baseline CK-MB elevations were associated with an increased risk of in-hospital all-cause mortality in acute type A and type B AD patients, and it was independently associated with poor prognosis in type A patients.
本研究旨在评估急性A型和B型主动脉夹层（AD）患者基线肌酸激酶同工酶（CK-MB）与院内全因死亡风险之间的关联，并探讨CK-MB的预测价值。
对552例急性AD患者（A型329例，B型223例）进行单中心回顾性分析。观察指标为院内全因死亡率。采用Kaplan-Meier曲线比较两组（CK-MB正常组和CK-MB升高组）的全因死亡风险。采用Cox回归模型和限制性立方样条（RCS）评估CK-MB与观察指标之间的关系。根据性别、年龄（<50岁或≥50岁）以及手术或血管内治疗进行分层分析。
Kaplan-Meier曲线显示，急性A型和B型AD患者不同CK-MB水平组的观察指标存在统计学显著差异。Cox回归分析显示，急性A型和B型AD患者CK-MB升高组的院内死亡风险均显著升高。RCS曲线显示，急性A型AD患者CK-MB与院内全因死亡率呈非线性J形相关，急性B型AD患者CK-MB与院内全因死亡率呈线性相关。
基线CK-MB升高与急性A型和B型AD患者院内全因死亡风险增加相关，且与A型患者预后不良独立相关。
