Coronary disease & ACSCohort study
Using Creatine Kinase-myocardial Band (CK-MB) and High-sensitivity Cardiac Troponin T (hs-cTnT) to Predict 30-Day Mortality After CABG
- multicenter cohort study
Authors' conclusion
The combined use of CK-MB and hs-cTnT enables a simple and robust risk-stratification strategy for early postoperative mortality, with direct implications for clinical surveillance and future cardiac surgery trials.
Study context
- Population
- Patients undergoing isolated coronary artery bypass grafting at hospitals in Innsbruck, Freiburg, Gothenburg, and Reykjavik
- Participants
- 9,856 patients
- Exposure
- Postoperative CK-MB and hs-cTnT, alone and combined, for 30-day all-cause mortality
Main finding
As reported in the abstract
Thirty-day all-cause mortality · 30 days
Thirty-day all-cause mortality
2.0%
Observational data: associations, not effects.
Further findings
Median peak values within 72 hours postsurgery
| Outcome | adjusted HR (per doubling in concentration) (95% CI) | P value | |
|---|---|---|---|
| 30-day all-cause mortality per doubling in biomarker concentration · 30 days — CK-MB · higher mortality risk; independent of EuroSCORE II | 1.95 (1.79–2.12) | P < 0.001 | |
| 30-day all-cause mortality per doubling in biomarker concentration · 30 days — hs-cTnT · higher mortality risk; independent of EuroSCORE II | 1.71 (1.61–1.82) | P < 0.001 | |
| 0.512Adjusted hazard ratio (log scale) |
Mortality risk, combined biomarker analysis (CK-MB top tertile)
| Comparison | adjusted HR (95% CI) | P value | |
|---|---|---|---|
| CK-MB top tertile and hs-cTnT mid tertile | 4.34 (1.78–10.62) | P < 0.001 | |
| CK-MB top tertile and hs-cTnT top tertile | 14.78 (6.85–31.88) | P < 0.001 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
AUC
| Outcome | CK-MB | hs-cTnT | Estimate | P value |
|---|---|---|---|---|
| Predictive accuracy (AUC) · similar | 0.787 | 0.784 | P = 0.99 |
Predictive accuracy (AUC)
- Stratification using Youden-derived thresholds identified distinct patient subgroups with limited overlap
Mortality risk, combined biomarker analysis (CK-MB top tertile)
- Mortality risk was increased only when CK-MB was in the top tertile and hs-cTnT in the mid or top tertile
Original publication
Using CK-MB and hs-cTnT to Predict 30-Day Mortality After CABG. JACC Adv. Published 25 September 2026. doi:10.1016/j.jacadv.2026.103284
Summarised from the published abstract; every number is checked against it