Atherosclerotic plaque burden and CK-MB enzyme elevation after coronary interventions : intravascular ultrasound...

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Biology

Background:

• Serum creatine kinase MB fraction (CK-MB) elevation post-percutaneous coronary intervention (PCI) is linked to mortality.
• The underlying cause of CK-MB elevation after PCI remains unclear.

Purpose of the Study:

• To investigate the relationship between pre-PCI atherosclerotic plaque burden and post-PCI CK-MB elevation.
• To test the hypothesis that higher plaque burden, assessed by intravascular ultrasound (IVUS), predicts CK-MB elevation.

Main Methods:

• A retrospective analysis of 2256 patients undergoing PCI before routine glycoprotein IIb/IIIa inhibitor use.
• Patients were stratified into three groups based on pre-PCI CK-MB levels.
• Pre-intervention IVUS was used to quantify plaque burden, positive remodeling, and calcification.

Main Results:

• Patients with higher CK-MB levels exhibited significantly greater plaque burden at both reference and lesion sites on IVUS.
• Positive remodeling was more prevalent in lesions associated with CK-MB elevation.
• Multivariate analysis identified de novo lesions, atheroablative techniques, plaque burden, and minimal lumen diameter as independent predictors of CK-MB elevation.

Conclusions:

• CK-MB elevation after PCI correlates with increased atherosclerotic plaque burden.
• Elevated CK-MB may serve as a marker for diffuse atherosclerotic disease or reflect intervention in more diseased vessels.