Department of Cardiology, 2 Medical School, Charles University, University Hospital Motol, Prague, Czech Republic.
Arch Med Sci. 2011 Feb;7(1):67-72. doi: 10.5114/aoms.2011.20606. Epub 2011 Mar 8.
Peri-procedural myocardial infarction (PMI) is a frequent and prognostically important complication of percutaneous coronary intervention (PCI). This study was designed to determine the predictors of PMI in patients pre-treated with statins.
A total of 418 stable angina pectoris patients taking statins and aspirin were included. All the patients underwent PCI. Serum concentrations of creatine kinase (CK-MB mass) and troponin I (TnI) were measured prior to and then within 16 to 24 hours after PCI. The incidence of PMI was assessed using the established criteria (≥ 3 times upper limit of normal).
Four hundred and eighteen stable patients (63 ±10 years, 68% males) were treated by PCI. The technical success rate of PCI was 99%. The incidence of PMI based on CK-MB mass or TnI release was 12% (PMI group). There were no significant differences in baseline clinical and procedural characteristics between PMI and non-PMI groups except for the balloon inflation time (40 ±44 s vs. 26 ±27 s; p = 0.02) and the proportion of treated type C lesions (42% vs. 28%; p = 0.03). In multivariate analysis, the independent predictors of PMI were balloon inflation time (OR = 1.01; 95% CI 1.001-1.020; p = 0.02) and pre-procedural level of C-reactive protein (OR = 1.38; 95% CI 1.059-1.808; p = 0.02).
These results suggest that C-reactive protein and balloon ischaemic time are independent predictors of PMI in stable angina patients pre-treated with statins.
经皮冠状动脉介入治疗（PCI）围手术期心肌梗死（PMI）是一种常见且具有重要预后意义的并发症。本研究旨在确定接受他汀类药物预处理的患者发生 PMI 的预测因素。
共纳入 418 例稳定型心绞痛且正在服用他汀类药物和阿司匹林的患者。所有患者均接受 PCI 治疗。PCI 术前和术后 16 至 24 小时内测量肌酸激酶同工酶（CK-MB 质量）和肌钙蛋白 I（TnI）的血清浓度。采用既定标准（≥正常值上限的 3 倍）评估 PMI 的发生率。
418 例稳定型患者（63 ±10 岁，68%为男性）接受 PCI 治疗。PCI 的技术成功率为 99%。根据 CK-MB 质量或 TnI 释放，PMI 的发生率为 12%（PMI 组）。PMI 组与非 PMI 组在基线临床和手术特征方面无显著差异，仅球囊扩张时间（40 ±44 s 比 26 ±27 s；p = 0.02）和处理 C 型病变的比例（42%比 28%；p = 0.03）不同。多变量分析显示，PMI 的独立预测因素为球囊扩张时间（OR = 1.01；95%CI 1.001-1.020；p = 0.02）和术前 C 反应蛋白水平（OR = 1.38；95%CI 1.059-1.808；p = 0.02）。
这些结果表明，C 反应蛋白和球囊缺血时间是稳定型心绞痛患者接受他汀类药物预处理后发生 PMI 的独立预测因素。
