Investigation of predictors of increased creatine kinase levels following vascular surgery and the association with peri-operative statin therapy : cardiovascular topic

Although peri-operative statin administration is likely to be cardioprotective, there remains a concern about the risk of rhabdomyolysis and associated renal failure following statin administration in the peri-operative period. The aim of this study was to determine independent predictors of creatine kinase (CK) elevation following vascular surgery.Design: A retrospective cohort study was conducted. A multivariate analysis using binary logistic regression was conducted of clinical, surgical and laboratory factors which may be associated with a CK exceeding five times the upper limit of normal (ULN).Results: Four independent predictors associated with a CK > 5 ULN were identified. Statin therapy was protective [odds ratio (OR) 0.096, 95% confidence interval (CI) 0.014-0.68, p = 0.019], and a serum creatinine > 180 µmol.l-1, positive serum troponins and embolectomy and/or fasciotomy were associated with CK elevation (OR 3.32, 95% CI: 1.03-10.7, p = 0.04; OR 5.84, 95% CI: 1.52-22.4, p = 0.01; OR 5.62, 95% CI: 1.14-27.8, p = 0.03 respectively). Statin therapy was associated with decreased mortality (OR 0.26, 95% CI: 0.08-0.86, p = 0.028).Conclusion: It may be preferable to continue statin therapy in vascular surgical patients even when CK is elevated, as this may decrease mortality if the CK elevation is in the presence of pre-existing renal dysfunction, peri-operative cardiac events or following embolectomy or fasciotomy. Further investigation is required to confirm this observation

Changes in Neutrophil Count; Creatine Kinases and Muscle Soreness after Repeated Bouts of Downhill Running

OBJECTIVE. A primary objective was to examine circulating neutrophil count after repeated bouts of downhill running. An additional aim was to determine creatine kinase (CK)levels during the initial 12 hours; after repeated DHRs. DESIGN. Eleven healthy; untrained Caucasian males performed 2 x 60 min bouts of DHR (-13.5); spaced 14 days apart; at a speed equal to 75VO2max on a level grade. Blood was collected before; after; and every hour for 12 hours; and every 24 hours for 6 days. Absolute neutrophil count; CK; and delayed-onset muscle soreness (DOMS) were assessed. Result were analysed using repeated measures ANOVA (p0.05) with appropriate post hoc tests. RESULT. There were no significant differences in neutrophil count (p