title: Incidence and Predictors of Cardiomyocyte Injury in Elective Coronary Angiography.
abstract: Coronary angiography is considered to be a safe tool for the evaluation of coronary artery disease and performed in approximately 12 million patients each year worldwide. The aim of our study was to investigate the frequency and predictors of cardiomyocyte injury in patients undergoing elective coronary angiography.
  
  
  
  A total of 749 consecutive patients who were scheduled to undergo elective coronary angiography were prospectively analyzed. High-sensitivity cardiac troponin T concentrations were measured both before and after elective coronary angiography (without intervention). Acute cardiomyocyte injury was predefined as an absolute increase in high-sensitivity cardiac troponin T of at least 7 ng/L (if also fulfilling a relative change of >20%).
  
  
  
  Acute cardiomyocyte injury was observed in 101 patients (13.5%, 95% confidence interval [CI], 11.1-16.2). It was independently associated with aortic valve stenosis (odds ratio [OR], 5.4; 95% CI, 3.0-9.8; P <.001), age (OR, 1.05; 95% CI, 1.02-1.08; P <.001), female sex (OR, 3.5; 95% CI, 1.8-6.8; P <.001), contrast volume (OR, 1.006; 95% CI, 1.001-1.012; P = .019 per 10 mL of contrast volume), documented cardiomyopathy (OR, 2.5; 95% CI, 1.0-6.0; P = .045), and mitral regurgitation (OR, 2.3; CI, 1.0-4.9; P = .033). In contrast, operator experience and extent of coronary artery disease were not found to be associated with acute cardiomyocyte injury.
  
  
  
  Cardiomyocyte injury accompanies elective coronary angiography in 1 of 8 patients. Sex, age, contrast agent volume, and ventricular disease, rather than the extent of coronary artery disease, independently predict cardiomyocyte injury. Further research aiming to reduce the incidence of cardiomyocyte injury seems warranted.
authors.affiliation: Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
authors.forename: Philipp
authors.initials: P
authors.lastname: Kreutzinger
authors.affiliation: Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland; Department of Internal Medicine, University Hospital Basel, Switzerland.
authors.forename: Karin
authors.initials: K
authors.lastname: Wildi
authors.affiliation: Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
authors.forename: Raphael
authors.initials: R
authors.lastname: Twerenbold
authors.affiliation: Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland; Department of Internal Medicine, University Hospital Basel, Switzerland.
authors.forename: Maria
authors.initials: M
authors.lastname: Rubini Gimenez
authors.affiliation: Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
authors.forename: Tobias
authors.initials: T
authors.lastname: Reichlin
authors.affiliation: Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland; Department of Internal Medicine, University Hospital Basel, Switzerland.
authors.forename: Cedric
authors.initials: C
authors.lastname: Jaeger
authors.affiliation: Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland; Department of Internal Medicine, University Hospital Basel, Switzerland.
authors.forename: Petra
authors.initials: P
authors.lastname: Hillinger
authors.affiliation: Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
authors.forename: Jasper
authors.initials: J
authors.lastname: Boeddinghaus
authors.affiliation: Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Nestelberger
authors.affiliation: Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Puelacher
authors.affiliation: Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland; Department of Internal Medicine, University Hospital Basel, Switzerland.
authors.forename: Fabio
authors.initials: F
authors.lastname: Stallone
authors.affiliation: Laboratory Medicine, University Hospital Basel, Switzerland.
authors.forename: Katharina
authors.initials: K
authors.lastname: Rentsch
authors.affiliation: Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Osswald
authors.affiliation: Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
authors.forename: Raban
authors.initials: R
authors.lastname: Jeger
authors.affiliation: Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Kaiser
authors.affiliation: Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland. Electronic address: Christian.Mueller@usb.ch.
authors.forename: Christian
authors.initials: C
authors.lastname: Mueller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography / Q000009:adverse effects*; D005260:Female; D006335:Heart Injuries / Q000097:blood / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013557:Switzerland / Q000453:epidemiology; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D020107:Troponin T
keywords: Coronary angiography; Myocardial infarction; Myocardial injury; Predictors of cardiomyocyte injury