27 August 2003
Percutaneous coronary intervention in the context of systemic inflammation: more injury and worse outcome
Salam M. SaadeddinMed Sci Monit 2003; 9(8): RA193-197 :: ID: 13126
Abstract
Minor myocardial injury (MMI), identified by elevated serum levels of cardiac markers, is not uncommon after successful, uncomplicated elective percutaneous coronary intervention (PCI) in patients with stable angina. Serum cardiac troponin, especially cardiac troponin I (cTnI), are more sensitive than serum creatine kinase – MB in detecting MMI. Occlusion of small side-branch vessels, visualized by angiography, may explain the mechanism of the MMI in some, but not all patients. Occlusion of small intramyocardial vessels, not visualized by angiography, might be the mechanism of MMI in these patients. Recent reports have shown that cardiac troponin I elevation after successful, uncomplicated elective PCI in patients with stable angina may be a marker of adverse long-term outcome. Also, it has recently been reported that increased serum C-Reactive protein (CRP) is common in patients with stable angina and is a significant and independent determinant of MMI after uncomplicated elective PCI, indicating involvement of the systemic inflammatory state in the etiology of this periprocedural myocardial injury. An intense inflammatory response is expected following PCI in patients with increased baseline CRP levels, which can cause small vessel occlusion and/or microembolization that will lead to troponin elevation. With these findings in mind, and with the observation that increased risk associated with systemic inflammation can be reduced with certain preventive therapies, CRP may help to identify those who would benefit most from these pharmacological therapies before coronary interventions.
Keywords: Angioplasty, Transluminal, Percutaneous Coronary - adverse effects
Editorial
01 April 2025 : Editorial
Editorial: Rapid Testing for the Avian Influenza A(H5N1) Virus is Urgently Required as Infections in Poultry and Dairy Cows are on the Rise, and so is Transmission to HumansDOI: 10.12659/MSM.949109
Med Sci Monit 2025; 31:e949109
In Press
Clinical Research
Longitudinal Evaluation of Metabolic Benefits of Inactivated COVID-19 Vaccination in Diabetic Patients in T...Med Sci Monit In Press; DOI: 10.12659/MSM.947450
Clinical Research
Impact of Voltage Level on Hospitalization and Mortality in Electrical Injury Cases: A Retrospective Analys...Med Sci Monit In Press; DOI: 10.12659/MSM.947675
Clinical Research
Comparative Study of Plantar Load and Foot Posture Characteristics in Male Elite Squash Players and Non-Ath...Med Sci Monit In Press; DOI: 10.12659/MSM.947828
Clinical Research
Dental Students’ Opinions on Use of Artificial Intelligence: A Survey StudyMed Sci Monit In Press; DOI: 10.12659/MSM.947658
Most Viewed Current Articles
17 Jan 2024 : Review article 8,071,874
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
16 May 2023 : Clinical Research 702,992
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
01 Mar 2024 : Editorial 30,169
Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and ...DOI :10.12659/MSM.944204
Med Sci Monit 2024; 30:e944204
28 Jan 2024 : Review article 24,060
A Review of IgA Vasculitis (Henoch-Schönlein Purpura) Past, Present, and FutureDOI :10.12659/MSM.943912
Med Sci Monit 2024; 30:e943912