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Optical coherence tomography-based predictors for creatine kinase-myocardial band elevation after elective percutaneous coronary intervention for in-stent restenosis

Authors
 Seung-Yul Lee  ;  Myeong-Ki Hong  ;  Dong-Ho Shin  ;  Jung-Sun Kim  ;  Byeong-Keuk Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Yangsoo Jang 
Citation
 CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Vol.85(4) : 564-572, 2015 
Journal Title
 CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS 
ISSN
 1522-1946 
Issue Date
2015
MeSH
Aged ; Biomarkers/blood ; Chi-Square Distribution ; Coronary Restenosis/diagnosis ; Coronary Restenosis/etiology ; Coronary Restenosis/therapy* ; Coronary Vessels/pathology* ; Creatine Kinase, MB Form/blood* ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Neointima ; Odds Ratio ; Percutaneous Coronary Intervention/adverse effects ; Percutaneous Coronary Intervention/instrumentation* ; Predictive Value of Tests ; Retreatment ; Risk Factors ; Stents* ; Time Factors ; Tomography, Optical Coherence* ; Treatment Outcome ; Up-Regulation ; Vascular Calcification/etiology ; Vascular Calcification/therapy
Keywords
in-stent restenosis ; neoatherosclerosis ; optical coherence tomography
Abstract
OBJECTIVES: 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). BACKGROUND: The impact of neointimal characteristics of ISR lesions on periprocedural myocardial injury has not been sufficiently investigated. METHODS: 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. RESULTS: 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), P < 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%, P < 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; P = 0.011] and TCFA (OR, 14.328; 95% CI, 1.118-183.628; P = 0.041) were independent predictors for post-PCI CK-MB elevation. CONCLUSIONS: 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.
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/ccd.25643/abstract
DOI
10.1002/ccd.25643
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Shin, Dong Ho(신동호) ORCID logo https://orcid.org/0000-0002-7874-5542
Lee, Seung Yul(이승율)
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139509
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