title: Predictors of coronary artery aneurysm after stent implantation in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention.
abstract: The clinical and angiographic predictors of coronary artery aneurysm (CAA) formation in patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) are not clear. This study aims to assess the predictors of CAA formation after primary PCI. 3,428 patients who underwent PCI for STEMI were enrolled. The average period of follow-up was mean 48 months (range 35-56 months) after PCI. During this time, 1,304 patients were underwent follow-up coronary angiography. CAA was detected in 21 patients (1.6 %). CAA occurred at the segment of stent implantation in all patients. The clinical and angiographic data were compared between patients with CAA group (n = 21) and without CAA group (n = 1,283). Patients who developed CAA had longer reperfusion time, higher high-sensitiviy C-reactive protein (hs-CRP) levels and neutrophil to lymphocyte ratio than those who had without CAA. Angiographically, CAA developed proximally located lesions and lesion length was significantly greater in patients with CAA than without CAA. Statin and beta-blocker discontinuation were found higher in stent-associated CAA. Every 1 mg/l increase in hs-CRP and implantation of drug eluting stent (DES) were independent predictor of CAA formation after STEMI. Baseline elevated inflammation status and DES implantation in the setting of STEMI may predict the CAA formation.
authors: Cardiology Department, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey, karabaymd@yahoo.com.
authors: Can Yucel
authors: CY
authors: Karabay
authors: Gonenc
authors: G
authors: Kocabay
authors: Ahmet
authors: A
authors: Guler
authors: Vecih
authors: V
authors: Oduncu
authors: Taylan
authors: T
authors: Akgun
authors: Arzu
authors: A
authors: Kalayci
authors: Alev
authors: A
authors: Kılıcgedik
authors: Onur
authors: O
authors: Tasar
authors: Sedat
authors: S
authors: Kalkan
authors: Ayhan
authors: A
authors: Erkol
authors: Akin
authors: A
authors: Izgi
authors: Ali Metin
authors: AM
authors: Esen
authors: Cevat
authors: C
authors: Kirma
mesh_terms: D000368:Aged; D003323:Coronary Aneurysm / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D017023:Coronary Angiography; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000295:instrumentation*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011474:Prosthesis Design; D065840:Protective Factors; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014421:Turkey; D018084:Ultrasonography, Interventional
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D018836:Inflammation Mediators; D008670:Metals