Increased CK-MB release is a "trade-off" for optimal stent implantation
an intravascular ultrasound study
Ioannis Iakovou, MD*,
Gary S. Mintz, MD*,
George Dangas, MD, PhD*,*,
Alexandre Abizaid, MD*,
Roxana Mehran, MD*,
Yoshio Kobayashi, MD*,
Alexandra J. Lansky, MD*,
Eve D. Aymong, MD, MSc*,
Eugenia Nikolsky, MD*,
Gregg W. Stone, MD*,
Jeffrey W. Moses, MD* and
Martin B. Leon, MD*
* Cardiovascular Research Foundation, Lenox Hill Heart and Vascular Institute, New York, New York, USA
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Figure 1 Creatine kinase-MB isoenzyme elevation (CK-MB) post percutaneous coronary intervention according to stent expansion. CK-MB release one to three times normal was similar in Group 1 (stent expansion <70%) vs. Group 2 (stent expansion 70% to 100%) vs. Group 3 (stent expansion >100%). However, there was a stepwise increase in CK-MB 3 to 5 times and >5 times normal in Group 1 vs. Group 2 vs. Group 3.
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Figure 2 One-year cumulative outcome. There was a stepwise decrease in death, multiple adverse cardiac events, and target lesion revascularization in Group 1 (stent expansion <70%) vs. Group 2 (stent expansion 70% to 100%) vs. Group 3 (stent expansion >100%). MACE = multiple adverse cardiac events; Q-W MI = Q-wave myocardial infarction; TLR = target lesion revascularization.
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Figure 3 The occurrence of any target lesion revascularization event decreased with increasing percent stent expansion (% stent expansion = final stent CSA/[proximal CSA + distal CSA]/2). CSA = cross-sectional area.
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