CREATINE KINASE IN PERIPROCEDURAL MYOCARDIAL INJURY AFTER PERCUTANEOUS CORONARY INTERVENTION

Anastasya V. Vorobyova; Victor A. Bart; Boris B. Bondarenko; Vladimir V. Dorofeykov; Oleg M. Kalinin; Elvira V. Kuleshova

doi:10.21638/11701/spbu11.2017.101

Authors

Anastasya V. Vorobyova Federal Almazov Northwest Medical Research Centre, 2, ul. Akkuratova, St. Petersburg, 197341, Russian Federation
Victor A. Bart Federal Almazov Northwest Medical Research Centre, 2, ul. Akkuratova, St. Petersburg, 197341, Russian Federation
Boris B. Bondarenko Federal Almazov Northwest Medical Research Centre, 2, ul. Akkuratova, St. Petersburg, 197341, Russian Federation
Vladimir V. Dorofeykov Federal Almazov Northwest Medical Research Centre, 2, ul. Akkuratova, St. Petersburg, 197341, Russian Federation
Oleg M. Kalinin Federal Almazov Northwest Medical Research Centre, 2, ul. Akkuratova, St. Petersburg, 197341, Russian Federation
Elvira V. Kuleshova Federal Almazov Northwest Medical Research Centre, 2, ul. Akkuratova, St. Petersburg, 197341, Russian Federation

DOI:

https://doi.org/10.21638/11701/spbu11.2017.101

Abstract

Patients with ischemic heart disease undergoing percutaneous coronary intervention are characterized by various degrees of myocardial damage. The purpose of the study is to investigate the dependence of micro-injuries of the myocardium on the nature of the damage to the coronary arteries and the features of the procedure during the interventional treatment in patients with stable angina.Myocardial damage was diagnosed based on the dynamics of cardiospecific biomarkers of creatine kinase-myocardial band isoenzyme before and 24 hours after intervention.Providing the analysis of the phenomenon in the totality of its characteristics, the use of multivariate statistics (principal component method, stepwise discriminant analysis) allowed not only to differentiate patients with or without periprocedural myocardial damage and to determine the possibility of their differentiation by the impacts of such characteristics as “the total number of inflations” and “total number of affected arteries”, but also to point out a level of creatine kinase before intervention as a sign of potential vulnerability/resistance of myocardium.The latter can be considered as a separate component characterizing the state of cardiomyocytes and the degree of risk of postprocedural myocardial damage. Thus, investigation of nature of the complication is important not only for its prevention but for study the whole cardioprotection issue.Refs 26. Figs 2. Tables 7.

Keywords:

stenosis of the coronary arteries, percutaneous coronary intervention, periprocedural myocardial damage, creatine phosphokinase, principal components, stepwise discriminant analysis, cardioprotection

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References

Mironova O. Iu. Klinicheskoe i prognosticheskoe znachenie infarkta miokarda, razvivshegosia v rezul’tate provedeniia planovoi koronarnoi angioplastiki u patsientov so stabil’noi ishemicheskoi bolezn’iu serdtsa. Dis. kand. med. nauk [Clinical and prognostic value of myocardial infarction, developed as a result of planned coronary angioplasty in patients with stable ischemic heart disease."> PhD diss. of medicine]. Moscow, 2015,114 p. (In Russian)

Califf R. M., Abdelmeguid A. E., Kunitz R. E. Myonecrosis after revascularization procedures. J. Am. Coll. Cardiol.,1998, vol. 31, no. 2, pp. 241–251.

Van Gaal W. J., Banning A. P. Diagnosing peri-procedural myocardial injury following percutaneous coronary intervention: replacing confusion with consensus. Heart, 2012, vol. 98, pp. 1473–1475.

Lansky A. J., Stone G. W. Periprocedural Myocardial Infarction: Prevalence, Prognosis, and Prevention.Circ. Cardiovasc. Interv.,2010, no. 3, pp. 602–610.

White H. D. Defining prognostically important criteria in the periprocedural PCI — Troponin Saga.Circ. Cardiovasc. Interv., 2012, vol. 5, pp. 142–145.

Bart A. G. Analiz mediko-biologicheskikh sistem. Metod chastichno obratnykh funktsii [Analysis of Biomedical Systems. The Method of Partially Inverse Functions]. St. Petersburg, St. Petersburg University Press,2003, 279 p. (In Russian)

Bondarenko B. B., Bart V. A., Demchenko E. A., Bart A. G., Zaslavskii M. L. Aktual’nye aspekty

metodologii kliniko-statisticheskogo analiza [Relevant aspects of the methodology of clinico-statistical

analysis]. Klinicheskaia i eksperimental’naia kardiologiia [Clinical and experimental cardiology]. Ed. by E. V. Shlyakhto. St. Petersburg, 2005, pp. 136–148 (In Russian)

Vorobyova A. V., Bondarenko B. B., Bart V. A., Dorofeikov V. V., Mashek O. N., Esipovich I. D.,

Zverev D. A., Kuleshova E. V. O faktorakh povrezhdeniia miokarda pri planovom chreskozhnom koronarnom vmeshatel’stve [On the factors of myocardial damage during elective percutaneous coronary intervention].

Vestnik of Saint Petersburg University. Series 11. Medicine, 2014, issue 1, pp. 168–179. (In Russian)

Shlyakhto E. V., Petrishchev N. N., Galagudza M. M., Vlasov T. D., Nifontov E. M."> Kardioprotektsiia: fundamental’nye i klinicheskie aspekty [Cardioprotection: fundamental and clinical aspects].

St. Petersburg,2013, 399 p. (In Russian)

Babu G. G., Walker J. M., Yellon D. M., Hausenloy D. J. Peri-procedural myocardial injury during

percutaneous coronary intervention: an important target for cardioprotection. Eur. Heart J.,201, vol. 32,no. 1, pp. 23–32.

Antman E. M., Morrow D. A. Biomarker release after percutaneous coronary intervention: a message from the heart. Circ. Cardiovasc. Interv., 2008, vol. 1, no. 1, pp. 3–6.

Dolci A., Panteghini M. The exciting story of cardiac biomarkers: from retrospective detection to

gold diagnostic standard for acute myocardial infarction and more. Clin. Chim. Acta, 2006, vol. 369, no. 2,pp. 179–187. DOI: 10.1016/j.cca.2006.02.042

Alpert J. S., Thygesen K., Antman E., Bassand J. P. Myocardial infarction redefined — a consensus

document of The Joint European Society of Cardiology.J. Am. Coll. Cardiol., 2000, vol. 36, no. 3, pp. 959–169.

Arai A. E. False positive or true positive troponin in patients presenting with chest pain but ‘normal’coronary arteries: lessons from cardiac MRI.Eur. Heart J.,2007, vol. 28, no. 11, pp. 1175–1177.

Lim C. C., van Gaal W. J., Testa L., Cuculi F., Arnold J. R., Karamitsos T., Francis J. M., Petersen S. E.,

Digby J. E., Westaby S., Antoniades C., Kharbanda R. K., Burrell L. M., Neubauer S., Banning A. P. With the

“universal definition,” measurement of creatine kinase-myocardial band rather than troponin allows more accurate diagnosis of periprocedural necrosis and infarction after coronary intervention. J. Am. Coll. Cardiol.,2011, vol. 57, no. 6, pp. 653–661.

Grines C. L., Dixon S. A nail in the coffin of troponin measurements after percutaneous coronary

intervention. J. Am. Coll. Cardiol., 2011, vol. 57, no. 6, pp. 662–663.

Bangalore S., Pursnani S., Kumar S., Bagos P. G. Percutaneous coronary intervention vs. optimal medical therapy for prevention of spontaneous myocardial infarction in subjects with stable ischemic heart diseas. Circulation, 2013, vol. 127, pp. 769–781. DOI: 10.1161/CIRCULATIONAHA.112.131961.

Zhang M., He H., Wang Z.-M., Xu Zh., Zhou N., Tao Zh., Chen B., Li Ch., Zhu T., Yang D., Wang L.,

Yang Zh. Diagnostic and prognostic value of minor elevated cardiac troponin levels for percutaneous coronary

intervention-related myocardial injury: a prospective, single-center and double-blind study. J. Biochem.

Res., 2014, vol. 28, no. 2, pp. 98–107.

Prasad A., Rihal C., Lennon R., Singh M., Jaffe A. S., Holmes D. R. Jr. Significance of periprocedural

myonecrosis on outcomes after percutaneous coronary intervention: an analysis of preintervention and postintervention troponin T levels in 5487 patients. Circ. Cardiovasc. Interv., 2008, vol. 1, no. 1, pp. 10–19.

Prasad A., Herrmann J. Myocardial infarction due to percutaneous coronary intervention. N. Engl. J. Med., 2011, vol. 364, no. 5, pp. 453–464.

Thygesen K., Alpert J. S., Jaffe A. S., Simoons M. L., Chaitman B. R., White H. D. Joint ESC/ACCF/

AHA /WHF task force for the universal definition of myocardial infarction. Third universal definition of

myocardial infarction. Eur. Heart. J., 2012, vol. 33, no. 20, pp. 2551–2567.

Smith S. C., Dove J. T., Jacobs A. K., Kennedy J. W., Kereiakes D., Kern M. J., Kuntz R. E., Popma J. J.,

Schaff H. V., Williams D. O., Gibbons R. J., Alpert J. P., Eagle K. A., Faxon D. P., Fuster V., Gardner T. J., Gregoratos

G., Russell R. O., Smith S. C. Jr. ACC/AHA guidelines of percutaneous coronary interventions (revision of the 1993 PTCA guidelines) — executive summary: a report of the American College of Cardiology. J. Am. Coll. Cardiol.,

2001, vol. 37, no. 8, pp. 2215–2239.

Lang T. A., Secic M. How to report statistics in medicine: annotated guidelines for authors, editors, and reviewers. Philadelphia, American College of Physicians, 2006, 490 p.

Tukey J. W. Exploratory Data Analysis. Reading, Mass, Addison Wesley Publishing Company, 1977,pp. XVI + 688.

Wallach’s Interpretation of diagnostic tests. Philadelphia, Lippincott Williams & Wilkins, 2007.

Solntsev V. N., Cherkashin D. V. Analiz korreliatsionnoi struktury faktorov serdechno-sosudistogo riska [Analysis of correlation structure of cardiovascular risk factors]. Bulletin of the Federal Almazov center of heart, blood and endocrinology, 2010, vol. 2, pp. 217–218. (In Russian).