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Review
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Korean J Med. 2006;71(1):299-299.
- Periprocedural Myonecrosis is associated with Adverse Cardiac Events after Drug-Eluting Stents Implantation
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Jae-Sik Jang, Myeong-Ki Hong, Duk-Woo Park, Young-Hak Kim, Cheol Whan Lee, Jae-Joong Kim, Seong-Wook Park, Seung-Jung Park
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- Periprocedural Myonecrosis is associated with Adverse Cardiac Events after Drug-Eluting Stents Implantation
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, , , , , , ,
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국립의료원 내과
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- Abstract
- Background : High level of creatine kinase myocardial band isoenzyme (CK-MB) elevation has been associated with late
mortality after coronary intervention. We sought to evaluate the impact of periprocedural myonecrosis on clinical events in
patients undergoing drug-eluting stents (DESs) implantation. Methods : A total of 1,807 consecutive patients (2,550 lesions) with
successful DESs implantation were followed for mean duration of 13¡¾7 months. Patients with acute myocardial infarction were
excluded. Based on the CK-MB levels after stenting, patients were classified into three groups: group I: normal CK-MB (n =
1,429, 79.1%), group II: 1 to 5 times normal CK-MB (n = 263, 14.6%), and group III: > 5 times normal CK-MB (n = 115, 6.4%).
Major adverse cardiac events (MACE) were defined as death, myocardial infarction, and target lesion revascularization. Results
: There were no significant differences in baseline clinical characteristics between the three groups. Patients with elevated
CK-MB levels showed longer stent length, more number of stents per lesion, and smaller postintervention minimal luminal
diameter. With increasing levels of periprocedural CK-MB, there was an increased incidence of MACE (4.7% in group I vs. 6.5%
in group II vs. 11.3% in group III, p = 0.002) and death (0.6% in group I vs. 1.5% in group II vs. 3.5% in group III, p = 0.012).
By multivariate analysis, periprocedural peak CK-MB level was independent predictor of MACE (HR 1.01, 95% CI 1.00 to 1.02;
p = 0.041) and death (HR 1.02, 95% CI 1.00 to 1.04; p = 0.049) in addition to left ventricular ejection fraction, cutting angioplasty,
and number of stents per lesion. Conclusions : Periprocedural myonecrosis was significantly associated with subsequent adverse
clinical events after DESs implantation.
Keywords :
