title: Attenuated plaque is associated with plaque prolapse accompanied by cardiac enzyme elevation after drug-eluting stent implantation.
abstract: OBJECTIVE
  This study aimed to evaluate the relationship between grayscale intravascular ultrasound-attenuated plaque (AP) and poststenting plaque prolapse (PP) as well as their influence on creatine kinase-myocardial band (CK-MB) elevation after drug-eluting stent (DES) implantation.
  
  
  BACKGROUND
  The relationship between baseline AP and poststenting PP and their impacts on percutaneous coronary intervention (PCI) are not well known.
  
  
  METHODS
  A total of 141 single, native, de-novo coronary lesions in 141 patients with normal pre-PCI CK-MB levels who underwent intravascular ultrasound before and after DES implantation were studied.
  
  
  RESULTS
  AP was found in 72 (51.1%) lesions and PP occurred in 43 (30.5%) lesions. Baseline AP was associated with greater plaque area, lesion eccentricity, and positive remodeling, and was associated with higher frequency of poststenting PP (47.2 vs. 13.0%, P<0.001) as well as greater poststenting PP volume (2.2±1.3 vs. 1.9±1.1 mm, P=0.045). Elevated CK-MB levels were observed in 34 (24.1%) lesions and significantly more frequently in patients with baseline AP and poststenting PP than without both of these findings. Multivariate analysis indicated that AP with PP was the predictor of post-PCI CK-MB elevation.
  
  
  CONCLUSIONS
  Baseline AP was associated with high-risk characteristics, higher frequency, and greater volume of poststenting PP accompanied by CK-MB elevation in patients with DES implantation.
authors.affiliation: aSixth Department of Cardiology bDepartment of Ultrasound cDepartment of Clinical Laboratories, Beijing Anzhen Hospital, Capital Medical University, Beijing, People's Republic of China.
authors.forename: Xiao-Fan
authors.initials: XF
authors.lastname: Wu
authors.forename: Cheng-Jun
authors.initials: CJ
authors.lastname: Guo
authors.forename: Yun-Peng
authors.initials: YP
authors.lastname: Chi
authors.forename: Ya
authors.initials: Y
authors.lastname: Yang
authors.forename: Rong
authors.initials: R
authors.lastname: Lu
authors.forename: Dong-Fang
authors.initials: DF
authors.lastname: He
authors.forename: Xiao-Jiang
authors.initials: XJ
authors.lastname: Zhang
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D052279:Creatine Kinase, MB Form / Q000097:blood*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D052279:Creatine Kinase, MB Form