Author + information
- Ahmet Çağrı Aykan,
- Tayyar Gökdeniz,
- Hüseyin Bektaş,
- Faruk Boyacı,
- İlker Gül,
- Ezgi Kalaycıoğlu,
- Turhan Turan and
- Şükrü Çelik
To date limited data is available regarding the occurrence and predictors of silent neuronal injury (SNI) after percutaneous coronary intervention (PCI). The aim of this study is to evaluate the incidence and predictors of SNI after coronary angiography and intervention by serial measurement of serum neuron specific enolase (NSE) in patients presented with acute coronary syndrome.
Ninety-eight consecutive patients presented with ACS who underwent coronary angiography and intervention were included in the study. NSE was studied before and 18 hour after the PCI. Clinical and echocardiographic characteristics were analyzed and independent predictors of SNI were evaluated.
NSE levels significantly increased after coronary angiography and intervention compared to baseline levels (22.03±27.70, 10.08±3.15 consecutively). Baseline characteristics were similar between groups (Table-1). Left ventricular ejection fraction in the SNI+ group was significantly lower than SNI- group (43.71±12.51%, 50.84±9.34%, p=0.002). Maximal CK-MB, Troponin-I, Syntax Score (SS), of SNI+ group were significantly higher than SNI- group (103.83±99.22, 51.92±78.33, p=0.006; 50.04±66.18, 19.18±30.50, p=0.002; 103.83±99.22, 51.92±78.33, p=0.006 and 50.04±66.18, 19.18±30.50, p=0.002 successively). SS and performing PCI were the independent predictors of SNI (p=0.009, OR=1.06, 95%CI=1.014-1.107, p=0.036, OR=4.262, 95%CI=1.097-16.56).
PCI and coronary artery lesion complexity may increase the risk of SNI in patients with acute coronary syndrome.
|Male n(%)||26 (83.8%)||49 (73.1%)||0.243|
|Body Mass Index, kg/m2||28.06±4.03||28.01±4.85||0.515|
|Hypertension, n(%)||10 (32.3%)||25 (37.3%)||0.627|
|Diabetes, n(%)||10 (32.3%)||24 (35.8)||0.730|
|Hyperlipidemia, n(%)||9 (28.1%)||22 (32.8%)||0.782|
|Smoking, n(%)||11 (35.5%)||20 (29.9%9||0.752|
|Atrial fibrillation, n(%)||2 (6.5%)||8 (11.9%)||0.404|
|Mean Arterial Pressure, mmHg||100.71±13.80||98.26±12.14||0.374|
|Percutaneous Coronary Intervention, n(%)||21 (67.7%)||30 (44.8%)||0.034|
|Fluoroscopy Time, min||6.37±4.23||4.70±4.16||0.069|
|estimated Creatinine Clearance, ml/min||103.65±30.51||99.10±34.47||0.530|
|Total Cholesterol, mg/dl||201.21±66.84||205.85±55.17||0.718|
|Mean Platelet Volume, femtolitre||8.27±1.51||8.21±0.93||0.797|
|Red cell Distribution Width, %||13.55±0.91||13.36±1.42||0.498|
|Left Atrial diameter, mm||38.29±4.09||38.51±5.85||0.853|
|Left Ventricular End Diastolic Diameter, mm||49.90±5.83||49.30±5.03||0.600|
|Left ventricular End Systolic Diameter, mm||36.10±5.76||33.39±6.00||0.037|
|Ejection Fraction, %||43.71±12.51||50.84±9.34||0.002|
|Asendan Aorta diameter, mm||34.71±4.11||34.57±4.20||0.875|