High coronary calcium score and post-procedural CK-MB are noninvasive predictors of coronary stent restenosis

Lee, Jaebeom; Choi, Yun‐Seok; Chung, Woo-Baek; Kwon, Ah Reum; Park, Chul‐Soo; Lee, Man-Young

doi:10.2147/cia.s125592

Cited by 4 publications

(4 citation statements)

References 29 publications

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“…Most of the patients improved. The most commonly used medications reported by hypertensive patients were angiotensin receptor antagonists, calcium channel blockers, ACE inhibitors, beta-blocker, alpha-blockers, thiazide, and non-thiazide diuretics [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…The present study demonstrated no significant correlations between calcium level in hypertensive patients and demographic characteristics of patients, home or current medications, ECHO findings, or procedures done; however, a significant correlation between the calcium level and CK level among patients with hypertension. One study by Lee et al (2017) showed that a high coronary calcium score with post-procedural CK-MB might be a valuable predictor for TLR after DES implantation [22]. Previous research found that blood CK activity can significantly rise without any clinically evident cardiac or skeletal muscle disorders when there is hypocalcemia.…”

Section: Discussionmentioning

confidence: 99%

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A Retrospective Cohort Study of the Association Between Calcium Serum Level and Hypertension in Older Adults

Sabah¹,

Zomia²,

Deajim³

et al. 2023

Cureus

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Introduction: One of the major global risk factors for cardiovascular morbidity and death is hypertension. Earlier research has been conducted on the connection between calcium consumption and blood pressure. Objective: This study aims to investigate the association between calcium serum levels and hypertension in older hypertensive adults. Methods: A retrospective cohort study of 121 of hypertension patients was conducted in Prince Faisal Bin Khalid Cardiac Center. The data of all patients were collected by records, including lab, pathology, and medical review, in order to determine the effects on patients, providers, and institutions. Statistical analyses were performed using SPSS Statistics version 26.0. A p-value of <0.05 was considered statistically significant. Results: The study included 121 adult hypertensive patients with a mean of age 60.29 ± 13.92. The majority of included patients were male (81%). More than one-third of patients were obese (39.7%), about one-third (33.9%) were overweight, and 26.4% of patients were in normal weight. The majority of patients had co-morbidities (68.3%); about one-half of them had diabetes mellitus (52.1%). The calcium level mean was 5.07 ± 1.26. The creatine kinase (CK) (initial day) mean ± SD was 813.22 ± 1146.37 became 221.4 ± 330.67 on the last day. The CK-myocardial band (CK-MB) (initial day) was 65.43 ± 118.9 and became 24.38 ± 23.26 on the last day. Additionally, the troponin (initial day) mean was 23.49 ± 104.26 and became 1.65 ± 2.66 on the last day. The most common discharge medications were anti-platelets (95%), beta-blockers (78.5%), statins (70.2%), and proton-pump inhibitors (PPI) (64.5%). The hospital stay days ranged from 1 to 20 days with a mean of 4.83 ± 3.38. The ICU stay days ranged from 1 to 15 days with a mean of 3.57 ± 2.72. Most of the patients (90.9%) improved. Conclusion: There is no significant correlation between calcium levels in hypertensive patients and the demographic characteristics of patients, home or current medications, ECHO findings, or procedures done. However, there is a significant correlation between the calcium level and CK level among patients with hypertension. Further investigations are required to verify the relationship between CK and calcium levels in hypertensive patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Retrospective Cohort Study of the Association Between Calcium Serum Level and Hypertension in Older Adults

Sabah¹,

Zomia²,

Deajim³

et al. 2023

Cureus

View full text Add to dashboard Cite

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“…[11,12] Incidence of restenosis is in association with factors including the type of stent (metallic or drug eluting), stent diameter and length, and the individual's atherosclerotic factors such as diabetes. [3,4] ISR diagnosis is made based on CICA. Although it is still the gold standard method of ISR diagnosis, its potential complications caused considerable trend toward non-invasive techniques.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of intraluminal stent enhancement in estimating coronary in-stent restenosis

Nogourani

Moradi

Khajouei

et al. 2020

JCIS

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Objective: In-stent restenosis (ISR) diagnosis is among the most serious complications of patients undergone stent implantation. Although coronary computed tomography angiography (CCTA) has been widely used for ISR assessing, stent narrow lumen and presence of stent’s struts artifacts have limited its efficacy. The use of quantitative techniques may provide more valuable findings for ISR diagnosis. The aim of this study is to assess the predictive value of a quantitative technique of ISR estimation based on stent intraluminal enhancement derived from CCTA. Materials and Methods: In the current study, 40 patients with the previous history of coronary artery diseases (CADs) and coronary stent placement who reexperienced CAD symptoms and referred for CCTA were assessed in 2017–2018. Stent intraluminal “enhancement value” (EV) was measured using calcium score and post-contrast images of CCTA. The cutoff point was determined using conventional invasive coronary angiography as the gold standard. Results: Total numbers of 58 stents were evaluated, in which stent intraluminal enhancement was assessed in initial, middle, and end sites of stent, achieved cutoff points for more than 50% of ISR were 204, 168, and 204 Hounsfield units, respectively. These cutoff points had diagnostic value of 77.5% for initial part, 86% for midpart, and 81% for end part, respectively. Conclusion: The use of quantitative method of stent intraluminal EV for ISR estimation has better diagnostic value in comparison to qualitative techniques that can help better clinical decision making. Moreover, measurements of this method are somewhat easier and also secondary artifacts of stent struts and calcified plaques would be eliminated.

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“…Furthermore, the definite mechanism is not completely clear (5). The research by Lee et al (6) showed that coronary artery calcification score and cardiac enzyme (CK-MB) could predict in-stent restenosis (ISR). Some scholars also noted that the distribution width of red blood cells reflecting the physiological state of the body could also predict ISR (7).…”

Section: Introductionmentioning

confidence: 99%

Analyzing the Application of Myocardial Blood Flow Index in the Diagnosis of In-Stent Stenosis

Qingfeng

et al. 2021

Iran J Radiol

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Background: In-stent restenosis (ISR) usually develops from stent neointimal hyperplasia (SNH), which will seriously weaken the effect of treatment. In this study, both SNH and ISR were classified as in-stent stenosis (ISS), and a non-invasive parameter – myocardial blood flow index (MBFI) was used to analyze its value in the diagnosis of stent abnormalities. Objectives: Analyzing the application of MBFI in the diagnosis of ISS. Patients and Methods: Clinical follow-up data for 572 patients with drug-eluting stent (DES) was collected continuously. Ninety cases were screened with the protocol of computed coronary tomography angiography (CCTA) and invasive coronary angiography (ICA) for the unrelieved symptoms. In-stent abnormalities included SNH (ISS < 50%) and ISR (ISS ≥ 50%). The ROC curve was analyzed using the optimal cutoff value of MBFI to evaluate the in-stent abnormalities. T-test of independent samples was used for the comparison data with normal distribution, and chi-square test was used for comparison of nominal variables P < 0.05 was considered statistically significant. Results: Frequency of ISS was not statistically different between genders (χ2 = 0.105) (P = 0.7463). The optimal cutoff value was 0.082 with the area under the curve (AUC) of 0.829 (P < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value were 91.4%, 89.1%, 84.2%, and 94.2%, respectively, and the accuracy was 90.0%. Among 39 cases with MBFI ≤ 0.082, 34 (87.18%, 34/39) were with ISS, including 18 (20%, 18/90) of SNH, and 16 (17.9%, 16/90) of ISR. In the 39 cases with MBFI ≤ 0.082, there were eight (20.5%, 8/39) presented new lesions, and seven (17.9%, 7/39) presented severe lesions. Conclusion: MBFI could be used for evaluating ISS, and more attention should be paid to the new accompanying lesions for the high risk of severe lesions.

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High coronary calcium score and post-procedural CK-MB are noninvasive predictors of coronary stent restenosis

Cited by 4 publications

References 29 publications

A Retrospective Cohort Study of the Association Between Calcium Serum Level and Hypertension in Older Adults

A Retrospective Cohort Study of the Association Between Calcium Serum Level and Hypertension in Older Adults

Diagnostic value of intraluminal stent enhancement in estimating coronary in-stent restenosis

Analyzing the Application of Myocardial Blood Flow Index in the Diagnosis of In-Stent Stenosis

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