Kaya Mehmet Gungor, Okyay Kaan, Yazici Huseyin, Sen Nihat, Tavil Yusuf, Turkoglu Sedat, Timurkaynak Timur, Ozdemir Murat, Cemri Mustafa, Yalcin Ridvan, Cengel Atiye
Department of Cardiology, Erciyes University, Kayseri, Turkey.
Coron Artery Dis. 2009 Mar;20(2):138-42. doi: 10.1097/MCA.0b013e328322cd48.
We sought to investigate the early and late effects of magnetic resonance imaging (MRI) on stent thrombosis and major adverse coronary events after coronary artery stent (CAS) implantation at a long-term follow-up period.
Forty-three patients (28 men, mean age 63+/-10 years) who underwent CAS implantation before MRI examination were included. MRI was performed on a 1.5-T MR-system with a phased array multicoil. An average of 1.3 stents per patient were implanted (1-4 stents). More than one MRI was performed for two patients. Patients who underwent MRI within 8 weeks after the procedure were included in the early-term group (17 patients), and those who underwent MRI after 8 weeks were included in the late-term group (26 patients).
Mean follow-up period was 36+/-15 months. There was no acute or subacute stent thrombosis. Late stent thrombosis that resulted in acute myocardial infarction was observed in a patient from the early group after an operation for prostate hyperplasia 5 months after MRI, and the patient underwent percutaneous coronary artery angioplasty. De-nova lesion was observed in four patients in the early group and two patients in the late group (P=0.14). In-stent restenosis was recorded in two patients in the early group and three patients in the late group (P=0.98). Composite major adverse cardiac events (acute coronary syndrome, myocardial infarction, death, and cerebrovascular event) were observed in seven of the early-group patients (41%), and in six of the late-group patients (23%) (P=0.20).
MRI can be safely performed in patients with CAS implantation both in the early and late course, and is not associated with an increased risk of major adverse clinical cardiac events at long-term follow-up.
我们试图在长期随访期内研究磁共振成像（MRI）对冠状动脉支架（CAS）植入术后支架血栓形成和主要不良冠状动脉事件的早期和晚期影响。
纳入43例在MRI检查前接受CAS植入的患者（28例男性，平均年龄63±10岁）。MRI在配备相控阵多线圈的1.5-T MR系统上进行。每位患者平均植入1.3个支架（1-4个支架）。两名患者接受了不止一次MRI检查。术后8周内接受MRI检查的患者纳入早期组（17例患者），术后8周后接受MRI检查的患者纳入晚期组（26例患者）。
平均随访期为36±15个月。未发生急性或亚急性支架血栓形成。早期组的一名患者在MRI检查后5个月因前列腺增生手术，术后发生导致急性心肌梗死的晚期支架血栓形成，该患者接受了经皮冠状动脉腔内血管成形术。早期组有4例患者和晚期组有2例患者出现新发病变（P=0.14）。早期组有2例患者和晚期组有3例患者记录到支架内再狭窄（P=0.98）。早期组7例患者（41%）和晚期组6例患者（23%）观察到复合主要不良心脏事件（急性冠状动脉综合征、心肌梗死、死亡和脑血管事件）（P=0.20）。
CAS植入患者在早期和晚期均可安全地进行MRI检查，且在长期随访中与主要不良临床心脏事件风险增加无关。
