Occurrence of Non-Q wave Myocardial Infarction Following Percutaneous Coronary Intervention in the Stent Era: Systematic Monitoring of the Three Markers of Myocardial Necrosis
| Autor: | Aleardo Maresta, Marco Balducelli, Elisabetta Varani, Giuseppe Vecchi, Giulia Ricci Lucchi, Cinzia Gatti |
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| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Population Myocardial Infarction QT interval Electrocardiography Necrosis Basal (phylogenetics) Internal medicine Troponin I medicine Creatine Kinase MB Form Humans Radiology Nuclear Medicine and imaging Prospective Studies cardiovascular diseases Myocardial infarction Angioplasty Balloon Coronary education Creatine Kinase Aged education.field_of_study business.industry Myocardium Stent Percutaneous coronary intervention medicine.disease Isoenzymes Conventional PCI Cardiology Female Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | Journal of Interventional Cardiology. 18:243-248 |
| ISSN: | 1540-8183 0896-4327 |
| Popis: | Objectives: To compare the elevation of the three markers total creatine kinase (CK), CK-MB mass, and troponin I (TnI) and their relationship with clinical and procedural characteristics following percutaneous coronary intervention (PCI). Methods: We prospectively evaluated 385 patients consecutively undergoing successful PCI. The three markers were systematically measured before and at 6, 12, and 24 hours after PCI. Any increase above the upper normal limit (UNL) of any marker has been considered abnormal when basal values were normal, while a further increase was needed when basal values were altered. Patients with ongoing acute myocardial infarction were excluded from the analysis. Results: TnI was above UNL in 183 patients (51%); in 138 (38.5%) it was the only marker altered. CK-MB mass was elevated in 12.8% patients, more than 3× UNL in 5.5% and more than 5× UNL in 2.8%. In over one half of these patients, CK-MB values peaked at 12 hours following PCI. Total CK was above UNL in 23 patients only (6.4%) and more than twice UNL in 5 (1.4%). Only 1 patient out of the 5 with CK-MB mass more than 10× UNL had total CK higher than twice UNL. In our population, post-PCI elevation of myocardial necrosis markers correlate with the occurrence of minor procedural complications (observed overall in 7.8% cases; TnI and/or CK-MB > 1×UNL 96% vs 47.5%, P < 0.001) and the presence of higher complexity clinical and/or procedural features, such as multivessel disease, multivessel or multilesion PCI, multiple stenting and use of glycoprotein IIb/IIIa inhibitors. Conclusions: The elevation of at least one biochemical marker of myocardial necrosis is frequent following successful PCI with routine stent implantation. CK-MB mass is the most practical marker, having optimal kinetic and peaking with the first 12–18 hours post-PCI. Definitive data on the prognostic role and the applicability for the diagnosis of myocardial infarction of minor elevation of CK-MB mass or isolated increase of TnI are lacking. |
| Databáze: | OpenAIRE |
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