| The assessment of Shin's method for the prediction of creatinine kinase-MB elevation after percutaneous coronary intervention: an intravascular ultrasound study. | |
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MedLine Citation:
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PMID: 20972833 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Cardiac enzyme release is common after percutaneous coronary intervention (PCI). At present there is no established relationship between the quantity of necrotic core and dense calcium, as assessed by Shin's method using intravascular ultrasound virtual histology (VH-IVUS), and post-PCI creatinine kinase-MB (CK-MB) elevation. A total of 112 consecutive patients with unstable angina and a normal pre-PCI CK-MB level were imaged using VH-IVUS. Patients were divided into 2 groups according to the presence (CK-MB group, n = 22) or absence (non CK-MB group, n = 90) of a post-PCI CK-MB elevation >1.0 the upper limit of normal (3.6 ng/ml). Using Shin's method contours were drawn around the IVUS catheter (instead of the lumen), and the vessel. Mean area and volume of necrotic core and dense calcium were significantly greater in CK-MB group than in non CK-MB group (1.7 ± 0.9 mm(2) vs. 0.9 ± 0.6 mm(2), P < 0.001; 17.2 ± 8.8 mm(3) vs. 8.8 ± 5.8 mm(3), P < 0.001, and 0.9 ± 0.6 mm(2) vs. 0.4 ± 0.4 mm(2), P = 0.001; 9.1 ± 5.8 mm(3) vs. 3.9 ± 3.7 mm(3), P < 0.001, respectively). Percent necrotic core and dense calcium areas calculated by external elastic membrane (EEM) area were significantly greater in CK-MB group than in non CK-MB group (11.9 ± 5.1 vs. 6.6 ± 4.0%, P < 0.001 and 6.5 ± 4.0 vs. 3.0 ± 2.9%, P < 0.001, respectively). In the multivariate analysis, dense calcium volume and percent necrotic core to EEM at the most diseased segment were the only independent predictors of post-PCI CK-MB elevation (odds ratio: 1.22; 95% confidence interval: 1.09-1.37, P < 0.001 and odds ratio: 1.26; 95% confidence interval: 1.12-1.43, P < 0.001). Lesions with a greater amount of dense calcium volume and percent necrotic core to EEM, which can be easily identified and quantified on VH-IVUS analyzed using Shin's method, are responsible for post-PCI CK-MB elevation. With a rapid analyzing time, Shin's method may increase the identification of high risk lesions likely to induce a post-procedural myocardial injury in the catheterization laboratory facilitating on-line clinical decision making. |
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Authors:
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Eun-Seok Shin; Hector M Garcia-Garcia; Scot Garg; Jongha Park; Shin-Jae Kim; Patrick W Serruys |
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Publication Detail:
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Type: Journal Article Date: 2010-10-24 |
Journal Detail:
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Title: The international journal of cardiovascular imaging Volume: 27 ISSN: 1875-8312 ISO Abbreviation: Int J Cardiovasc Imaging Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-07-27 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100969716 Medline TA: Int J Cardiovasc Imaging Country: United States |
Other Details:
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Languages: eng Pagination: 883-92 Citation Subset: IM |
Affiliation:
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Ulsan University Hospital, University of Ulsan College of Medicine, 290-3 Jeonha-dong, Dong-gu, Ulsan, 682-714, South Korea, ses@uuh.ulsan.kr. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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