Does Diagnostic Coronary Angiography Induce Significant Coronary Microembolization in Stable, Ischemic Patients? A Prospective Study

Katritsis, Demosthenes G.; Korovesis, Socrates; Karvouni, Evangelia; Giazitzoglou, Eleftherios; Paxinos, George; Haliassos, Alexander

doi:10.1111/j.1540-8183.2006.00159.x

Cited by 3 publications

(2 citation statements)

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“…The exact pathophysiologic mechanisms ultimately resulting in periprocedural acute cardiomyocyte are unknown, but may include direct trauma during contact of catheters and wires with cardiomyocytes in the left ventricle; microembolization of air, debris, and plaque from the aortic wall, aortic valve, or ostium of the left and right coronary arteries [21][22][23][24][25] ; transient myocardial ischemia due to the replacement of blood with the contrast agent in the coronary arteries 25 ; or a combination of ischemic and toxic injury inducing the high viscosity and osmolarity of the contrast agents. Mechanisms may be similar to those of contrastinduced nephropathy.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Predictors of Cardiomyocyte Injury in Elective Coronary Angiography

Kreutzinger

Wildi

Twerenbold

et al. 2016

The American Journal of Medicine

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Section: Discussionmentioning

confidence: 99%

Incidence and Predictors of Cardiomyocyte Injury in Elective Coronary Angiography

Kreutzinger

Wildi

Twerenbold

et al. 2016

The American Journal of Medicine

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“…Categorical data are expressed as frequencies and percentages, and were compared using the χ2 or Fisher’s exact test, as appropriate. Continuous variables with normal distribution are expressed as mean±SD and were compared using the Student’s t-test.…”

Section: Methodsmentioning

confidence: 99%

Predictors and clinical implication of high-sensitivity cardiac troponin-I elevation following diagnostic cardiac catheterisations

et al. 2017

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ObjectivesAlthough diagnostic coronary angiography (CAG) is performed worldwide, procedure-related myocardial necrosis (PMN) following diagnostic catheter-based procedures has not been well investigated. The aim of this study was to determine clinical and procedural factors associated with PMN, using a high-sensitivity cardiac troponin I (hs-cTnI) assay, and to investigate the clinical implications of PMN.MethodsAmong 697 patients undergoing elective CAG and pre- and post-procedural hs-cTnI (pre-TnI, post-TnI, respectively) measurements, a total of 538 patients (124 female) were evaluated, with 2.2% lost during follow-up. Minor PMN was defined as post-TnI above the sex-specific upper reference limit (URL), with a 20% increase from the pre-TnI level. Major PMN was defined as post-TnI above 5x the URL. Clinical and procedural factors predicting PMN and the association between PMN and major adverse cardiac events (MACE) following CAG were examined.ResultsPMN of any type was detected in 178 patients (33.0%), while major PMN was observed in 32 patients (5.9%). Female sex, estimated glomerular filtration rate, procedural time, left ventricular end-diastolic pressure (LVEDP) and fractional flow reserve measurement independently predicted any PMN; whereas, only LVEDP and log-transformed N-terminal pro-brain natriuretic peptide independently predicted major PMN. The incidence of MACE was significantly associated with major PMN. Cox proportional-hazards models revealed that major PMN, pre-TnI, and the absence of statin use were independently associated with MACE.ConclusionsDiagnostic cardiac catheteriation may highlight cardiomyocyte susceptibility to stress in patients with or without CAD. CAG-related major myocardial injury might be associated with future adverse cardiac events independently of the presence or absence of functional stenosis.

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Subtle myocardial damage associated with diagnostic coronary angiography alone

et al. 2010

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Does Diagnostic Coronary Angiography Induce Significant Coronary Microembolization in Stable, Ischemic Patients? A Prospective Study

Abstract: Detectable embolization with subsequent subclinical myonecrosis is an unlikely event.

Cited by 3 publications

References 17 publications

Incidence and Predictors of Cardiomyocyte Injury in Elective Coronary Angiography

Incidence and Predictors of Cardiomyocyte Injury in Elective Coronary Angiography

Predictors and clinical implication of high-sensitivity cardiac troponin-I elevation following diagnostic cardiac catheterisations

Subtle myocardial damage associated with diagnostic coronary angiography alone

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