Optical coherence tomography‐based predictors for creatine kinase‐myocardial band elevation after elective percutaneous coronary intervention for in‐stent restenosis. Issue 4 (1st September 2014)

• Record Type: Journal Article
• Authors: Lee, Seung‐Yul; Hong, Myeong‐Ki; Shin, Dong‐Ho; Kim, Jung‐Sun; Kim, Byeong‐Keuk; Ko, Young‐Guk; Choi, Donghoon; Jang, Yangsoo
• Is Part Of: Catheterization and cardiovascular interventions. Volume 85:Issue 4(2015:Mar. 01)
• Page Start: 564
• Page End: 572
• Publication Date: 2014-09-01
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.25643
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd25643-sec-0001" sec-type="section"> <title>Objectives</title> <p>We evaluated whether morphological characteristics of neointimal tissue of in‐stent restenosis (ISR) lesions assessed by optical coherence tomography (OCT) affect periprocedural elevation of creatine kinase‐myocardial band (CK‐MB).</p> </sec> <sec id="ccd25643-sec-0002" sec-type="section"> <title>Background</title> <p>The impact of neointimal characteristics of ISR lesions on periprocedural myocardial injury has not been sufficiently investigated.</p> </sec> <sec id="ccd25643-sec-0003" sec-type="section"> <title>Methods</title> <p>A total of 125 patients with ISR lesions underwent elective percutaneous coronary intervention (PCI) and pre‐PCI OCT examination. Measurements of CK‐MB were performed upon hospitalization, before PCI, and every 8 hr for 24 hr after PCI. CK‐MB elevation was defined as levels above the 99th percentile of the upper reference limit. Neoatherosclerosis was defined as neointima with lipid or calcification.</p> </sec> <sec id="ccd25643-sec-0004" sec-type="section"> <title>Results</title> <p>Post‐PCI CK‐MB elevation was observed in 20 (16.0%) patients. The maximum length of consecutive cross‐sections with neoatherosclerosis on the longitudinal axis of the stent was significantly larger in patients with post‐PCI CK‐MB elevation than in those without [8.8 mm (1.5–10.4) vs. 0.0 mm (0.0–1.0), <italic>P</italic> < 0.001], and thin‐cap fibroatheroma (TCFA) were more frequently observed at the site of minimal lumen cross‐sectional area in patients with post‐PCI CK‐MB elevation (55.0% vs. 1.9%, <italic>P</italic> < 0.001). Multivariate analysis revealed that the maximum length of segments with neoatherosclerosis [odds ratio (OR), 1.463; 95% confidence interval (CI), 1.090–1.962; <italic>P</italic> = 0.011] and TCFA (OR, 14.328; 95% CI, 1.118–183.628; <italic>P</italic> = 0.041) were independent predictors for post‐PCI CK‐MB elevation.</p> </sec> <sec id="ccd25643-sec-0005" sec-type="section"> <title>Conclusions</title> <p>A greater axial length of neoatherosclerosis and the presence of TCFA at the most stenotic site were significantly associated with post‐PCI CK‐MB elevation in ISR lesions. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>