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Int J Cardiol. 2011 Jan 7;146(1):80-5. doi: 10.1016/j.ijcard.2010.06.010. Epub 2010 Jul 1.

Impact of plaque morphology on creatine kinase-MB elevation in patients with elective stent implantation.

Author information

1
Cardiology, Tsuchiura Kyodo Hospital, Tsuchiura, Japan. yonetsu@gmail.com

Abstract

BACKGROUNDS:

The association between percutaneous coronary intervention (PCI) and subsequent myonecrosis has been widely recognized, and worse prognosis has been reported among patients with elevated post-PCI biomarkers. We used optical coherence tomography (OCT) to study the relationship between pre-PCI plaque morphology and post-PCI creatine kinase-MB (CK-MB) elevation.

METHODS:

One hundred and twenty-five patients with normal pre-PCI CK-MB levels underwent OCT examination before nonemergency stent implantation. Patients were divided into two groups according to the presence (Group CK, n=35) or absence (Group NCK, n=90) of post-PCI CK-MB elevation ≥ upper limit of the normal range. Clinical and the OCT findings were compared between the two groups.

RESULTS:

Elevated CK-MB levels was observed in 35 patients (28%). The CK-MB elevation was associated with elevated white blood cell count, type B2/C lesions, the presence of thin cap fibroatheroma (TCFA), plaque rupture, and lipid quadrants. In the multivariate analysis, the presence of TCFA (OR 4.68, 95% CI 1.88-11.64, p=0.001) and type B2/C lesions (OR 4.20, 95% CI 1.30-13.59, p=0.02) were independent predictors of post-PCI CK-MB elevation.

CONCLUSIONS:

TCFA and angiographically complex lesion morphology can predict post-PCI CK-MB elevation in patients treated with elective stent implantation. OCT may be useful in stratifying the risk for nonemergency stent implantation.

PMID:
20591515
DOI:
10.1016/j.ijcard.2010.06.010
[Indexed for MEDLINE]
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