Predictors of coronary intervention-related myocardial infarction in stable angina patients pre-treated with statins
Abstrakt
Introduction: Pen-procedural myocardial infarction (PMI) is a frequent and prognostically important complication of percutaneous coronary intervention (PCI). This study was designed to determine the predictors of PMI in patients pre-treated with statins.
Material and methods: A total of 418 stable angina pectoris patients taking statins and aspirin were included. All the patients underwent PCI.
Serum concentrations of creatine kinase (CK-MB mass) and troponin I (TnI) were measured prior to and then within 16 to 24 hours after PCI. The incidence of PMI was assessed using the established criteria (>= 3 times upper limit of normal).
Results: Four hundred and eighteen stable patients (63 +/- 10 years, 68% males) were treated by PCI. The technical success rate of PCI was 99%.
The incidence of PMI based on CK-MB mass or TnI release was 12% (PMI group). There were no significant differences in baseline clinical and procedural characteristics between PMI and non-PMI groups except for the balloon inflation time (40 +/- 44 s vs. 26 +/- 27 s; p = 0.02) and the proportion of treated type C lesions (42% vs. 28%; p = 0.03).
In multivariate analysis, the independent predictors of PMI were balloon inflation time (OR = 1.01; 95% CI 1.001-1.020; p = 0.02) and pre-procedural level of C-reactive protein (OR = 1.38; 95% CI 1.059-1.808; p = 0.02). Conclusions: These results suggest that C-reactive protein and balloon ischaemic time are independent predictors of PMI in stable angina patients pre-treated with statins.