• Media type: E-Article
  • Title: Does Diagnostic Coronary Angiography Induce Significant Coronary Microembolization in Stable, Ischemic Patients? A Prospective Study
  • Contributor: KATRITSIS, DEMOSTHENES; KOROVESIS, SOCRATES; KARVOUNI, EVANGELIA; GIAZITZOGLOU, ELEFTHERIOS; PAXINOS, GEORGE; HALIASSOS, ALEXANDER
  • imprint: Wiley, 2006
  • Published in: Journal of Interventional Cardiology
  • Language: English
  • DOI: 10.1111/j.1540-8183.2006.00159.x
  • ISSN: 0896-4327; 1540-8183
  • Keywords: Cardiology and Cardiovascular Medicine ; Radiology, Nuclear Medicine and imaging
  • Origination:
  • Footnote:
  • Description: <jats:p> <jats:italic> <jats:bold>Background:</jats:bold> Although microembolization during percutaneous coronary interventions is a frequent event, the extent of possible microembolization during diagnostic coronary angiography is unknown. The aim of the study was to investigate whether diagnostic coronary angiography results in coronary microembolization and consequent subtle, subclinical myocardial necrosis with enzyme elevations.</jats:italic> </jats:p><jats:p> <jats:italic> <jats:bold>Methods:</jats:bold> Fifty‐three consecutive patients underwent diagnostic coronary angiography due to inducible ischemia. Creatine kinase MB isoenzyme (CK MB) and cardiac troponin I (cTnI) were used as sensitive surrogate markers of myocardial necrosis. Serial measurements, before, and 6 and 24 hours following a diagnostic procedure, were performed.</jats:italic> </jats:p><jats:p> <jats:italic> <jats:bold>Results:</jats:bold> Baseline cTnI was below the limits of detection in all patients (&lt;0.20 ng/mL), except for one patient with 1.31 ng/mL. Baseline median CK‐MB was 1.05 ng/mL (interquartile range, 0.80–1.56 ng/mL) (</jats:italic> <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="#f1"> <jats:italic>Fig. 1</jats:italic> </jats:ext-link> <jats:italic>). Both at 6 and 24 hours, no patients had any increase in cTnI, with the exception of a minor increase to 0.22 ng/mL at 24 hours in one patient. At 6 hours, 25 patients had decreases in CK MB, while 22 had increases (exact P = 0.77). At 24 hours, 26 patients had decreases in CK MB and 19 patients had increases.</jats:italic> </jats:p><jats:p><jats:fig><jats:caption><jats:p>Evolution of creatine kinase MB measurements in 53 patients at baseline, 6 hours, and 24 hours after angiography. Troponin I measurements were almost ubiquitously below the limit of detection (see text).</jats:p></jats:caption><jats:graphic xmlns:xlink="http://www.w3.org/1999/xlink" position="anchor" xlink:href="urn:x-wiley:08964327:media:JOIC159:JOIC_159_f1"><jats:alt-text>image</jats:alt-text></jats:graphic></jats:fig></jats:p><jats:p> <jats:italic> <jats:bold>Conclusions:</jats:bold> Detectable embolization with subsequent subclinical myonecrosis is an unlikely event.</jats:italic> </jats:p>
  • Access State: Open Access