Association of baseline C‐reactive protein levels with periprocedural myocardial injury in patients undergoing percutaneous bifurcation intervention: A CACTUS study subanalysis

Niccoli, Giampaolo; Sgueglia, Gregory A.; Latib, Azeem; Crea, Filippo; Colombo, Antonio

doi:10.1002/ccd.25102

Cited by 12 publications

(7 citation statements)

References 52 publications

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“…The sample size calculation was based on previous studies that investigated the correlation between inflammation biomarkers and PMI, and prognosis after PCI. Significant correlations were observed in the retrospective studies that included no more than 4,500 patients (15,18,19) and in the prospective studies that included no more than 100 patients (20).…”

Section: Sample Sizementioning

confidence: 87%

Impact of increased inflammation biomarkers on periprocedural myocardial infarction in patients undergoing elective percutaneous coronary intervention: a cohort study

Zhao

et al. 2020

J Thorac Dis

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Background: The fact that each inflammatory indicator has a forecasting capacity on the occurrence of periprocedural myocardial infarction (PMI) has a controversial existence. The purpose of this study was to explore the role of inflammation biological indicators on PMI in a group of patients undergoing selective percutaneous coronary intervention (PCI). Methods: The study was carried out both in a retrospective and prospective manner in 7,413 and 1,189 subjects, respectively. In the retrospective cohort study, the association between inflammation biomarkers and PMI was assessed by univariate and multivariate logistic regression. WBC, CRP, and NLR were distributed using k-means clustering into a virtual variable "Inflammatory Trend", and multivariate logistic regression and subgroup analysis were performed. In the prospective cohort study, the endpoints were PMI, cardiovascular death or cardiac arrest. The chi-square test was performed to calculate the relative risk (RR). Results: In the retrospective cohort study, except WBC, CRP, NLR and virtual variable "Inflammatory trend" were independent risk factors for PMI. The subgroup analysis revealed that CRP can serve as the most stable predictor. In the prospective cohort study, WBC (RR =1.134, P=0.416) has no effect on the incidence of PMI. However, an elevation in the incidence of PMI was observed with an increase of NLR (RR =1.354, P=0.041) and CRP (RR =1.412, P=0.025). Conclusions: In patients with elective PCI for single-vessel lesions, high CRP increases the risk for PMI.The increase of NLR was an independent risk factor for PMI, especially for patients with hypertension and under the age of 70. WBC has no influence on the occurrence of PMI.

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Section: Sample Sizementioning

confidence: 87%

Impact of increased inflammation biomarkers on periprocedural myocardial infarction in patients undergoing elective percutaneous coronary intervention: a cohort study

Zhao

et al. 2020

J Thorac Dis

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“…Several studies have identified risk factors associated with PCI related myocardial injury or myocardial infarction. These include, age, 3,14 renal Values are shown as mean AE SEM or n (%); PCI, Percutaneous coronary intervention; ns, non-significant dysfunction, 3,14,15 diabetes mellitus, 16,17 systemic inflammation, [18][19][20][21] and dyslipidemia. [22][23][24] However, there is conflicting evidence about the relationship between hypertension and PCI related myocardial damage.…”

Section: Discussionmentioning

confidence: 99%

Myocardial damage associated with elective percutaneous coronary intervention in Chinese patients: a retrospective study

Sun

et al. 2020

J Int Med Res

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Objective: To determine the prevalence of percutaneous coronary intervention (PCI) related myocardial damage (injury or myocardial infarction), investigate several cardiac biomarkers, explore possible risk factors and assess survival in patients undergoing elective PCI. Methods: Patients >18 years of age who had undergone an elective PCI at Huashan hospital in Shanghai, China from October 2016 to June 2017 and had baseline and post-PCI results available for four cardiac biomarkers (cTnT, CK-MB mass, hs-CRP and NT-ProBNP) were eligible. Patients were separated into two groups according to whether or not they had PCI related myocardial damage. Results: Of the 143 patients who were eligible for the study, 75 (52%) were classified as 'controls,' and 68 (48%) had PCI related myocardial damage. Of the 68 patients, 64 (45%) had PCI related myocardial injury and 4 (3%) had PCI related myocardial infarction. Elderly Chinese patients, with high systolic blood pressure on admission and who required multiple coronary segments for PCI had a high risk of myocardial damage. Relative cTnT or relative CK-MB mass may be useful cardiac biomarkers for monitoring PCI related myocardial damage, especially at 24h post-PCI. There was no significant difference in survival rates between controls and those with myocardial complications.

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“…Between January 2015 to November 2018, 5732 patients treated with elective PCI were recruited at Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University. Similar to previous studies (18,19), we excluded patients with elevated CK-MB or TnI levels before the procedure (≥1× upper limits of normal (ULN) levels) and adverse cardiovascular events, such as persistent refractory closure of coronary artery induced death or MI with or without emergency bypass surgery. Patients with renal or cardiac dysfunction (eGFR ≤30 mm/min/1.73 m 2 or NT-proBNP ≥2,000 pg/mL) were also excluded.…”

Section: Patientsmentioning

confidence: 99%

β-blocker use before elective percutaneous coronary intervention as a risk factor for periprocedural myocardial injury incidence in male patients below 75 years old: a single-center retrospective study

Wang

et al. 2021

Ann Palliat Med

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Background: β-blockers are indicated in several cardiovascular diseases. However, data are limited on their effect on the periprocedural myocardial injury (PMI) incidence. This study was designed to evaluate the impact of using β-blockers before elective percutaneous coronary intervention (PCI) on PMI incidence.Methods: This study included 4,027 patients who underwent elective PCI and had no elevated serum troponin I (TnI) or creatine kinase-MB (CK-MB) levels before PCI. Patients were divided into four groups based on gender and age (cut-off point 75 years). Serum TnI and CK-MB levels were measured before and every eight hours after the procedure. PMI was defined as postprocedural TnI or CK-MB ≥5 times the upper limits of normal (ULN) values. Logistic regression analysis including factors such as age, sex, prior β-blocker therapy, previous MI, length of implanted stents, characteristics of lesion and so on was performed to assess the effects of prior β-blocker therapy on the incidence of PMI.Results: In 2,332 male patients <75 years old, PMI incidence was higher in the β-blocker pre-usage subgroup than the no β-blocker pre-usage subgroup (16.4% vs. 11.7%, respectively; P=0.001). For the female patients ≥75 years old, the β-blocker pre-usage subgroup had a lower PMI incidence compared with the no β-blocker pre-usage subgroup (18.2% vs. 31.7%, respectively; P=0.012). In logistic regression analysis, the total length of implanted stents was a risk factor for PMI incidence in all patients. Also, β-blocker pre-usage was an independent risk factor for PMI in male patients <75 years old (HR =1.424, 95% CI: 1.088-1.864; P=0.01). However, we did not observe a significant effect in female patients ≥75 years old.Conclusions: Our study indicates that the PCI-PMI association depends on age and gender groups, β-blocker use before PCI is associated with increased PMI incidence in male patients <75 years old.

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Association of baseline C‐reactive protein levels with periprocedural myocardial injury in patients undergoing percutaneous bifurcation intervention: A CACTUS study subanalysis

Abstract: In the setting of true coronary bifurcations treated by DES, baseline CRP levels were significantly associated with both the incidence and the extent of PMI.

Cited by 12 publications

References 52 publications

Impact of increased inflammation biomarkers on periprocedural myocardial infarction in patients undergoing elective percutaneous coronary intervention: a cohort study

Impact of increased inflammation biomarkers on periprocedural myocardial infarction in patients undergoing elective percutaneous coronary intervention: a cohort study

Myocardial damage associated with elective percutaneous coronary intervention in Chinese patients: a retrospective study

β-blocker use before elective percutaneous coronary intervention as a risk factor for periprocedural myocardial injury incidence in male patients below 75 years old: a single-center retrospective study

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