title: Intracoronary electrocardiogram recording with a bare-wire system: perioperative ST-segment elevation in the intracoronary electrocardiogram is associated with myocardial injury after elective coronary stent implantation.
abstract: OBJECTIVE
  With an intracoronary electrocardiogram (IcECG) recording with insulated polymer-coated guidewire without balloon catheter, we sought to examine the association between ST-segment elevation in the IcECG after elective stenting and myocardial injury.
  
  
  BACKGROUND
  An IcECG is a sensitive method to detect local myocardial ischemia. Occasionally, persistent ST-segment elevation in the IcECG was recorded after successful coronary intervention. Conventionally IcECG was recorded with a guidewire and over-the-wire system.
  
  
  METHODS
  Patients who underwent elective stenting were enrolled (n = 339). The IcECG both at baseline and after procedure were obtained with a guidewire with an insulating coated shaft suitable for IcECG recording. The presence of chest pain after percutaneous coronary intervention was recorded. Cardiac biomarkers were examined 18 h after the procedure.
  
  
  RESULTS
  The ST-segment elevation in the IcECG after procedure was recorded in 65 patients, and no change was recorded in 274 patients. Troponin-T, creatine phosphokinase, and creatine kinase MB isoform after the procedure were significantly higher in patients with post-procedural ST-segment elevation in the IcECG than patients without ST-segment elevation. Multivariate analysis demonstrated that ST-segment elevation in the IcECG is an independent predictor of post-procedural myocardial injury. The incidence of ST-segment elevation in the IcECG was significantly higher in patients with post-procedural chest pain than patients without chest pain (p < 0.001).
  
  
  CONCLUSIONS
  We demonstrated a facile method to record IcECG with a guidewire with a polymer-coated shaft. The IcECG is a useful method for predicting post-procedural myocardial injuries.
authors.affiliation: Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan. uetani@med.nagoya-u.ac.jp
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Uetani
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Amano
authors.forename: Soichiro
authors.initials: S
authors.lastname: Kumagai
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Ando
authors.forename: Kiminobu
authors.initials: K
authors.lastname: Yokoi
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Yoshida
authors.forename: Bunichi
authors.initials: B
authors.lastname: Kato
authors.forename: Masataka
authors.initials: M
authors.lastname: Kato
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Marui
authors.forename: Michio
authors.initials: M
authors.lastname: Nanki
authors.forename: Tatsuaki
authors.initials: T
authors.lastname: Matsubara
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.forename: Hideo
authors.initials: H
authors.lastname: Izawa
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D015415:Biomarkers; D002637:Chest Pain; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000293:injuries*; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy*; D009206:Myocardium; D019990:Perioperative Care; D015607:Stents / Q000009:adverse effects*; D013997:Time Factors; D014336:Troponin
chemical_list: D015415:Biomarkers; D014336:Troponin