A postprocedural relative coronary flow velocity reserve <0.78 after coronary stenting was associated with a higher incidence of cardiac troponin T elevation (52.6% vs 5.6%, P<0.001).
Observational (n=55)
Is abnormal relative coronary flow velocity reserve (rCVR <0.78) after coronary intervention associated with cardiac marker elevation?
A persistent reduction in relative coronary flow velocity reserve (rCVR <0.78) after successful coronary stenting is strongly associated with periprocedural myocardial injury, likely due to microvascular embolization.
Absolute Event Rate: 52.6% vs 5.6%
p-value: p=<0.001
BACKGROUND: Residual reduction of relative coronary flow velocity reserve (rCVR) after successful coronary intervention has been related to microvascular impairment. However, the incidence of cardiac enzyme elevation as a surrogate marker of an underlying embolic myocardial injury in these cases has not been studied. METHODS AND RESULTS: A series of 55 consecutive patients with successful coronary stenting, periprocedural intracoronary Doppler analysis, and determination of creatine kinase (CK; upper limit of normal ULN for women 70 IU/L, for men 80 IU/L) and cardiac troponin T (cTnT; bedside test, threshold 0.1 ng/mL) before and 6, 12, and 24 hours after intervention were studied. Postprocedural rCVR was the only intracoronary Doppler parameter that independently correlated with cTnT (r=-0.498, P1 times the ULN in 36.8% and 5.6% (P=0.005) of patients, respectively. CONCLUSIONS: Cardiac marker elevation can frequently be found after coronary procedures that are associated with a persistent reduction of rCVR, indicating procedural embolization of atherothrombotic debris with microvascular impairment and myocardial injury as a potential underlying mechanism.
Herrmann et al. (2001) conducted an observational in Patients with successful coronary stenting (n=55). Postprocedural rCVR <0.78 vs. Postprocedural rCVR ≥0.78 was evaluated on Incidence of cTnT elevation (p=<0.001). A postprocedural relative coronary flow velocity reserve <0.78 after coronary stenting was associated with a higher incidence of cardiac troponin T elevation (52.6% vs 5.6%, P<0.001).
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