Elevated serum creatine kinase predicts first-ever myocardial infarction

A 12-year population-based cohort study in Japan, the Suita study

Makoto Watanabe, Tomonori Okamura, Yoshihiro Kokubo, Aya Higashiyama, Akira Okayama

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: In myocardial infarction (MI), it is well known that serum creatine kinase (s-CK) increases after onset, but it is unclear whether s-CK elevates before MI onset. The present analysis examined whether elevated s-CK levels predicted first-ever MI or stroke. Methods: This study was a population-based cohort study in a Japanese urban area. Study subjects were comprised of 5026 initially healthy Japanese (2370 men and 2656 women, mean age: 54.5 years) without a history of MI or stroke. They were followed-up for 11.8 years on average, and 103 MIs (definite: 45; probable: 58) and 168 strokes (definite: 126; probable: 42) were observed. There was no subject who developed MI just at baseline (the follow-up period among those with definite MI was, at earliest, 0.20 years). Results: The adjusted hazard ratio for definite MI was 4.18 (95% confidence interval 1.66-10.53) with s-CK levels of ≥200 IU/l, compared with the reference category (s-CK levels of ≤99 IU/l), whereas no relationship was observed between s-CK levels and the risk for stroke. With regard to definite MI, an interaction between s-CK levels and dyslipidaemia was observed. Among subjects with hypercholesterolaemia, the hazard ratio linearly elevated with increased s-CK levels. On the other hand, no linear elevation was observed among subjects without hypercholesterolaemia (P for interaction = 0.011). Conclusions: The present study suggested that screening for elevated s-CK levels in initially healthy Japanese subjects was useful to predict first-ever MI in the future, especially in subjects with dyslipidaemia. Published by Oxford University Press on behalf of the International Epidemiological Association.

Original languageEnglish
Article numberdyp212
Pages (from-to)1571-1579
Number of pages9
JournalInternational Journal of Epidemiology
Volume38
Issue number6
DOIs
Publication statusPublished - 2009 Jun 25
Externally publishedYes

Fingerprint

compound A 12
Creatine Kinase
Japan
Cohort Studies
Myocardial Infarction
Serum
Population
Stroke
Dyslipidemias
Hypercholesterolemia
Healthy Volunteers
Confidence Intervals

Keywords

  • Cohort studies
  • Creatine kinase
  • Myocardial infarction
  • Stroke
  • Urban population

ASJC Scopus subject areas

  • Epidemiology

Cite this

Elevated serum creatine kinase predicts first-ever myocardial infarction : A 12-year population-based cohort study in Japan, the Suita study. / Watanabe, Makoto; Okamura, Tomonori; Kokubo, Yoshihiro; Higashiyama, Aya; Okayama, Akira.

In: International Journal of Epidemiology, Vol. 38, No. 6, dyp212, 25.06.2009, p. 1571-1579.

Research output: Contribution to journalArticle

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abstract = "Background: In myocardial infarction (MI), it is well known that serum creatine kinase (s-CK) increases after onset, but it is unclear whether s-CK elevates before MI onset. The present analysis examined whether elevated s-CK levels predicted first-ever MI or stroke. Methods: This study was a population-based cohort study in a Japanese urban area. Study subjects were comprised of 5026 initially healthy Japanese (2370 men and 2656 women, mean age: 54.5 years) without a history of MI or stroke. They were followed-up for 11.8 years on average, and 103 MIs (definite: 45; probable: 58) and 168 strokes (definite: 126; probable: 42) were observed. There was no subject who developed MI just at baseline (the follow-up period among those with definite MI was, at earliest, 0.20 years). Results: The adjusted hazard ratio for definite MI was 4.18 (95{\%} confidence interval 1.66-10.53) with s-CK levels of ≥200 IU/l, compared with the reference category (s-CK levels of ≤99 IU/l), whereas no relationship was observed between s-CK levels and the risk for stroke. With regard to definite MI, an interaction between s-CK levels and dyslipidaemia was observed. Among subjects with hypercholesterolaemia, the hazard ratio linearly elevated with increased s-CK levels. On the other hand, no linear elevation was observed among subjects without hypercholesterolaemia (P for interaction = 0.011). Conclusions: The present study suggested that screening for elevated s-CK levels in initially healthy Japanese subjects was useful to predict first-ever MI in the future, especially in subjects with dyslipidaemia. Published by Oxford University Press on behalf of the International Epidemiological Association.",
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AB - Background: In myocardial infarction (MI), it is well known that serum creatine kinase (s-CK) increases after onset, but it is unclear whether s-CK elevates before MI onset. The present analysis examined whether elevated s-CK levels predicted first-ever MI or stroke. Methods: This study was a population-based cohort study in a Japanese urban area. Study subjects were comprised of 5026 initially healthy Japanese (2370 men and 2656 women, mean age: 54.5 years) without a history of MI or stroke. They were followed-up for 11.8 years on average, and 103 MIs (definite: 45; probable: 58) and 168 strokes (definite: 126; probable: 42) were observed. There was no subject who developed MI just at baseline (the follow-up period among those with definite MI was, at earliest, 0.20 years). Results: The adjusted hazard ratio for definite MI was 4.18 (95% confidence interval 1.66-10.53) with s-CK levels of ≥200 IU/l, compared with the reference category (s-CK levels of ≤99 IU/l), whereas no relationship was observed between s-CK levels and the risk for stroke. With regard to definite MI, an interaction between s-CK levels and dyslipidaemia was observed. Among subjects with hypercholesterolaemia, the hazard ratio linearly elevated with increased s-CK levels. On the other hand, no linear elevation was observed among subjects without hypercholesterolaemia (P for interaction = 0.011). Conclusions: The present study suggested that screening for elevated s-CK levels in initially healthy Japanese subjects was useful to predict first-ever MI in the future, especially in subjects with dyslipidaemia. Published by Oxford University Press on behalf of the International Epidemiological Association.

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