• Taishi Yonetsu, Tsunekazu Kakuta, Tetsumin Lee, Kentaro Takahashi, Ginga Yamamoto, Yoshito Iesaka, Hideomi Fujiwara, and Mitsuaki Isobe.
• Cardiology, Tsuchiura Kyodo Hospital, Tsuchiura, Japan. yonetsu@gmail.com
• Int. J. Cardiol. 2011 Jan 7; 146 (1): 80-5.

BackgroundsThe association between percutaneous coronary intervention (PCI) and subsequent myonecrosis has been widely recognized, and worse prognosis has been reported among patients with elevated post-PCI biomarkers. We used optical coherence tomography (OCT) to study the relationship between pre-PCI plaque morphology and post-PCI creatine kinase-MB (CK-MB) elevation.MethodsOne hundred and twenty-five patients with normal pre-PCI CK-MB levels underwent OCT examination before nonemergency stent implantation. Patients were divided into two groups according to the presence (Group CK, n=35) or absence (Group NCK, n=90) of post-PCI CK-MB elevation ≥ upper limit of the normal range. Clinical and the OCT findings were compared between the two groups.ResultsElevated CK-MB levels was observed in 35 patients (28%). The CK-MB elevation was associated with elevated white blood cell count, type B2/C lesions, the presence of thin cap fibroatheroma (TCFA), plaque rupture, and lipid quadrants. In the multivariate analysis, the presence of TCFA (OR 4.68, 95% CI 1.88-11.64, p=0.001) and type B2/C lesions (OR 4.20, 95% CI 1.30-13.59, p=0.02) were independent predictors of post-PCI CK-MB elevation.ConclusionsTCFA and angiographically complex lesion morphology can predict post-PCI CK-MB elevation in patients treated with elective stent implantation. OCT may be useful in stratifying the risk for nonemergency stent implantation.Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

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