Effects of direct stent implantation and conventional stent implantation on minor myocardial injury.
Direct coronary stenting without balloon predilation has the potential benefits of a reduced risk of extended dissections, reduced fluoroscopy exposure, reduced procedural time, and potential cost savings. The purpose of the study was to compare the effects of angiographically successful direct stent implantation and conventional stent implantation (stent implantation following predilation) on minor myocardial injury characterized by cardiac troponin I (cTn-I), and cardiac troponin T (cTn-T) elevation. The authors prospectively studied 42 patients who had successful direct stent implantation, and 49 patients who had successful conventional stent implantation. Blood samples for measurement of cTn-I and cTn-T were taken before, and immediately after the procedure, and every 6 hours for the first 24 hours. cTn-T elevation was observed in 6 patients (14.3%) in the direct stent implantation group, and in 16 patients (32.6%) in the conventional stent implantation group (p: 0.03). Similarly cTn-I elevation was more frequent in the conventional stent implantation group (20 patients, 40.8%) than direct stent implantation group (7 patients, 16.7%, p: 0.02). Stent implantation following predilation is more frequently associated with postprocedural minor myocardial injury than direct stent implantation.
Okmen
Ertan
E
Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey. ertanokmen@hotmail.com
Cam
Nese
N
Sanli
Arda
A
Yapici
Fikri
F
Uyarel
Huseyin
H
Vural
Mutlu
M
Ozturk
Recep
R
D000787:Angina Pectoris / Q000628:therapy; D000789:Angina, Unstable / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D002404:Catheterization; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003627:Data Interpretation, Statistical; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D013997:Time Factors; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood*
D019210:Troponin I; D020107:Troponin T