Document Detail


Impact of coronary plaque composition on cardiac troponin elevation after percutaneous coronary intervention in stable angina pectoris: a computed tomography analysis.
MedLine Citation:
PMID:  22595407     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The authors used multidetector computed tomography (MDCT) to study the relation between culprit plaque characteristics and cardiac troponin T (cTnT) elevation after percutaneous coronary intervention (PCI).
BACKGROUND: Percutaneous coronary intervention is often complicated by post-procedural myocardial necrosis manifested by elevated cardiac biomarkers.
METHODS: Stable angina patients (n = 107) with normal pre-PCI cTnT levels underwent 64-slice MDCT before PCI to evaluate plaque characteristics of culprit lesions. Patients were divided into 2 groups according to presence (group I, n = 36) or absence (group II, n = 71) of post-PCI cTnT elevation ≥3 times the upper limit of normal (0.010 ng/ml) at 24 h after PCI.
RESULTS: Computed tomography attenuation values were significantly lower in group I than in group II (43.0 [26.5 to 75.7] HU vs. 94.0 [65.0 to 109.0] HU, p < 0.001). Remodeling index was significantly greater in group I than in group II (1.20 ± 0.18 vs. 1.04 ± 0.15, p < 0.001). Spotty calcification was observed significantly more frequently in group I than in group II (50% vs. 11%, p < 0.001). Multivariate analysis showed presence of positive remodeling (remodeling index >1.05; odds ratio: 4.54; 95% confidence interval: 1.36 to 15.9; p = 0.014) and spotty calcification (odds ratio: 4.27; 95% confidence interval: 1.30 to 14.8; p = 0.016) were statistically significant independent predictors for cTnT elevation. For prediction of cTnT elevation, the presence of all 3 variables (CT attenuation value <55 HU; remodeling index >1.05, and spotty calcification) showed a high positive predictive value of 94%, and their absence showed a high negative predictive value of 90%.
CONCLUSIONS: MDCT may be useful in detecting which lesions are at high risk for myocardial necrosis after PCI.
Authors:
Hiroaki Watabe; Akira Sato; Daiki Akiyama; Yuki Kakefuda; Toru Adachi; Eiji Ojima; Tomoya Hoshi; Nobuyuki Murakoshi; Tomoko Ishizu; Yoshihiro Seo; Kazutaka Aonuma
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  59     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-18     Completed Date:  2012-07-13     Revised Date:  2012-11-01    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1881-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina, Stable / blood*,  surgery*
Angioplasty, Balloon, Coronary*
Coronary Artery Disease / blood*,  surgery*
Female
Humans
Male
Middle Aged
Plaque, Atherosclerotic / blood*,  radiography*
Tomography, X-Ray Computed*
Troponin T / blood*
Chemical
Reg. No./Substance:
0/Troponin T
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2012 May 22;59(21):1889-90   [PMID:  22595408 ]
J Am Coll Cardiol. 2012 Sep 11;60(11):1029-30, author reply 1030   [PMID:  22954246 ]

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