Angiographic adverse events during percutaneous coronary intervention fail to predict creatine kinase-MB elevation

Area of Science:

• Cardiology
• Interventional Cardiology
• Biomarkers

Background:

• Coronary interventions carry risks of myocardial injury, indicated by elevated cardiac enzymes like creatine kinase-MB (CK-MB).
• Identifying predictors of CK-MB elevation is crucial for patient management and risk stratification.
• Aggressive detection of angiographic adverse events is a potential strategy to anticipate post-procedural CK-MB elevations.

Purpose of the Study:

• To investigate whether the aggressive detection of angiographic adverse events during coronary intervention can predict subsequent CK-MB elevations.
• To identify specific angiographic events or procedural factors associated with CK-MB elevation.

Main Methods:

• Prospective observational study involving 251 coronary intervention procedures.
• Utilized fluoroscopy and cine angiography for aggressive detection of angiographic adverse events.
• Monitored CK-MB levels post-procedure to assess for myocardial injury.

Main Results:

• 53% of procedures had at least one angiographic adverse event; 24% of procedures showed CK-MB elevation.
• Slow coronary flow (P=0.002) and post-procedural chest discomfort (P=0.007) were significant predictors of CK-MB elevation.
• CK-MB elevation occurred in 12% of procedures without angiographic adverse events, accounting for 25% of all CK-MB elevations.

Conclusions:

• CK-MB elevation can occur even after angiographically uncomplicated coronary interventions.
• Aggressive detection of angiographic adverse events alone is insufficient to predict all instances of myocardial injury.
• Routine monitoring of cardiac enzymes remains necessary to detect myocardial injury post-coronary intervention.