Lee Jae-Beom, Choi Yun-Seok, Chung Woo-Baek, Kwon Ami, Park Chul-Soo, Lee Man-Young
Anyang Sam Hospital.
Division of Cardiology, Department of Internal Medicine, Youido St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Clin Interv Aging. 2017 Feb 17;12:399-404. doi: 10.2147/CIA.S125592. eCollection 2017.
High coronary calcium score (CCS) and post-procedural cardiac enzyme may be related with poor outcomes in patients with coronary stent implantation.
A total of 1,072 patients (63.2% male, mean age: 61.7±10.3 years) who underwent coronary multi-detect computed tomography at index procedure and follow-up coronary angiography (CAG) after drug-eluting stent (DES) were divided into two groups: those with and without target lesion revascularization (TLR; >50% reduction in luminal stent diameter or angina symptoms on follow-up CAG). The CCSs for predicting stent revascularization were elucidated.
There were no significant differences between the two groups with regard to risk factors. The initial CCS was significantly higher in the TLR group (1,102.4±743.7 vs 345.8±51.05, =0.04). After adjustment of significant factors for TLR, only CCS and post-procedural creatine kinase MB form (CK-MB) elevation were significant predictors of coronary artery TLR. Receiver operation curve revealed that >800 in CCS had 69% in sensitivity and 88% in specificity about predicting the TLR.
High CCS with post-procedural CK-MB might be the useful predictors for TLR after DES implantation.
高冠状动脉钙化评分（CCS）和术后心肌酶可能与冠状动脉支架植入患者的不良预后相关。
共有1072例患者（男性占63.2%，平均年龄：61.7±10.3岁）在初次手术时接受了冠状动脉多层计算机断层扫描，并在药物洗脱支架（DES）植入后进行了随访冠状动脉造影（CAG），这些患者被分为两组：有和没有靶病变血运重建（TLR；随访CAG时管腔支架直径减少>50%或出现心绞痛症状）的患者。阐明了用于预测支架血运重建的CCS。
两组在危险因素方面无显著差异。TLR组的初始CCS显著更高（1102.4±743.7对345.8±51.05，P=0.04）。在对TLR的显著因素进行调整后，只有CCS和术后肌酸激酶MB同工酶（CK-MB）升高是冠状动脉TLR的显著预测因素。受试者操作曲线显示，CCS>800对预测TLR的敏感性为69%，特异性为88%。
高CCS合并术后CK-MB可能是DES植入后TLR的有用预测指标。
