Using New Predictor of Coronary Artery Disease,
Docs May Be Able to Prevent Future Heart
Johns Hopkins Medicine
By more closely scrutinizing levels of creatinine, a
breakdown product of muscle, doctors may be able to prevent
future heart attacks in people who present at hospitals
with chest pain, a Johns Hopkins study reveals.
For several years, doctors have known that individuals
with high levels of creatinine, an indication of kidney
failure, are at increased risk of developing coronary
artery disease. A wide range of levels considered normal,
however, exists. To see if high-normal levels of creatinine
could predispose a person to poor outcomes, Johns Hopkins
doctors prospectively followed 459 patients with ongoing
chest pain who were admitted to the hospital because of a
suspected heart attack. They discovered that among patients
with high-normal creatinine, 22 percent suffered a
subsequent myocardial infarction, revascularization
(surgery to restore blood supply) or death by 120 days, in
comparison with 13 percent of patients with low-normal
levels of the white crystalline compound.
"In evaluating patients with chest pain, if there is
even a mild elevation of creatinine in the high-normal
range, doctors should think twice about how they triage
those patients," said Charles Henrikson, a cardiology
fellow at Johns Hopkins who presented the research March 8
during the American College of Cardiology's annual meeting.
Working up these individuals more aggressively, he said,
could help better identify individuals at risk and save
Henrikson's collaborators were David Bush, Eric Howell
and Nisha Chandra-Strobos.
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