Prognosis of patients with different peak serum creatine kinase levels after first myocardial infarction

The extent to which patients with low peak serum creatine kinase(CK) at their first myocardial infarction differ from patientswith high CK levels in terms of risk for subsequent ischaemicevents was investigated in 266 patients who survived the first48 h from the onset of infarction. All patients were followedup for one year. Four groups were formed based on peak CK200,201–400, 401–800 and >800 IU l^-1. During follow-upthe incidence of mortality was 15% (N=39), non-fatal re-infarction9% (N=23), and angina 53% (N=140). Hospital mortality was significantlyhigher (P<0.02) in the highest CK-group (16%), but the incidenceof non-fatal re-infarction, angina pectoris and late mortalitywas similar in the four groups. In hospital survivors, ischaemicST-changes during pre-discharge symptom limited bicycle stresstest and multiple vessel disease were equally distributed inall four groups. We conclude that while hospital mortality is directly relatedto peak CK, there is no relationship between peak CK and latemortality, non-fatal re-infarctions, or recurrent angina. Accordingly,diagnostic and therapeutic procedures in the individual patientsare notinfluenced by the amount of serum CK released duringacute infarction.