title: Angiographic adverse events during percutaneous coronary intervention fail to predict creatine kinase-MB elevation.
abstract: We attempted to determine if aggressive detection of angiographic adverse events during coronary intervention could predict subsequent creatine kinase (CK)-MB elevations. During coronary intervention, both fluoroscopy and cine angiography were used to detect angiographic adverse events. At least one angiographic adverse event occurred in 133/251 (53%) of procedures. CK-MB elevation occurred in 24% of procedures. Slow flow during the procedure (P=0.002) and chest discomfort at the end of the procedure (P=0.007) were the strongest predictors of CK-MB elevation. Among procedures with no angiographic adverse events, CK-MB elevation occurred in 15/121 (12%), accounting for 25% of CK-MB elevations. We conclude that CK-MB elevation occurs after angiographically uncomplicated coronary interventions even when angiographic adverse events are aggressively detected. Routine monitoring of cardiac enzymes is necessary to detect all patients who will experience myocardial injury after coronary intervention.
authors.affiliation: Department of Cardiology, Geisinger Medical Center, Danville, Pennsylvania 17822, USA. jblankenship@geisinger.edu
authors.forename: James C
authors.initials: JC
authors.lastname: Blankenship
authors.forename: M Ashequl
authors.initials: MA
authors.lastname: Islam
authors.forename: G Craig
authors.initials: GC
authors.lastname: Wood
authors.forename: Elias A
authors.initials: EA
authors.lastname: Iliadis
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D019917:Blood Vessel Prosthesis Implantation; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000201:enzymology* / Q000628:therapy; D003326:Coronary Circulation; D052279:Creatine Kinase, MB Form / Q000097:blood*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging* / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000627:therapeutic use; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012107:Research Design; D012680:Sensitivity and Specificity; D015607:Stents; D013318:Stroke Volume; D017211:Treatment Failure
chemical_list: D015415:Biomarkers; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D052279:Creatine Kinase, MB Form