Evaluation of silent brain injury in patients undergoing aorto-ostial coronary stent implantation

Autor: Ufuk Yildirim, Abdulkadir Kara, Muhammet Uyanik, Ahmet Onur Kocasari, Ahmet Cinar, Metin Coksevim, Bahattin Avci, Korhan Soylu, Okan Gulel
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Annals of Medicine, Vol 56, Iss 1 (2024)
Druh dokumentu: article
ISSN: 07853890
1365-2060
0785-3890
DOI: 10.1080/07853890.2024.2402950
Popis: Background Aorto-ostial (AO) coronary interventions may be associated with multiple problems, including the potential embolization of atherothrombotic debris into the aorta and systemic circulation. Such embolization could theoretically lead to stroke or silent brain injury (SBI). In this study, we aimed to investigate whether there is an increased risk of SBI in patients undergoing AO stent implantation.Methods Fifty-five consecutive patients undergoing AO stenting and 55 consecutive patients undergoing non-AO stenting were included. Venous blood samples were obtained before and 12 h after the procedure to measure neuron-specific enolase (NSE), which is a sensitive marker of brain injury. Newly developed NSE elevation after the procedure in an asymptomatic patient was defined as SBI.Results SBI was detected in 24 (43.6%) patients in the AO stenting group and 17 (30.9%) patients in the non-AO stenting group (p = .167). Although the SBI rates were statistically comparable between the groups, the presence of significant (≥50%) AO stenosis was found to be an independent predictor of SBI in multivariate logistic regression analysis [odds ratio (OR) 2.856; 95% confidence interval (CI) 1.057-7.716; p = .038]. A longer procedure time was another independent predictor for the development of SBI (OR 1.037; 95% CI 1.005-1.069; p = .023).Conclusion This study suggests that AO stenting may be associated with an increased risk of SBI if the lesion in the ostium is significant.
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