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Predictors of coronary artery aneurysm after stent implantation in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

The International Journal of Cardiovascular Imaging volume 30, pages 1435–1444 (2014)Cite this article

Abstract

The clinical and angiographic predictors of coronary artery aneurysm (CAA) formation in patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) are not clear. This study aims to assess the predictors of CAA formation after primary PCI. 3,428 patients who underwent PCI for STEMI were enrolled. The average period of follow-up was mean 48 months (range 35–56 months) after PCI. During this time, 1,304 patients were underwent follow-up coronary angiography. CAA was detected in 21 patients (1.6 %). CAA occurred at the segment of stent implantation in all patients. The clinical and angiographic data were compared between patients with CAA group (n = 21) and without CAA group (n = 1,283). Patients who developed CAA had longer reperfusion time, higher high-sensitiviy C-reactive protein (hs-CRP) levels and neutrophil to lymphocyte ratio than those who had without CAA. Angiographically, CAA developed proximally located lesions and lesion length was significantly greater in patients with CAA than without CAA. Statin and beta-blocker discontinuation were found higher in stent-associated CAA. Every 1 mg/l increase in hs-CRP and implantation of drug eluting stent (DES) were independent predictor of CAA formation after STEMI. Baseline elevated inflammation status and DES implantation in the setting of STEMI may predict the CAA formation.

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Affiliations

  1. Cardiology Department, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey

    Can Yucel Karabay, Ahmet Guler, Vecih Oduncu, Taylan Akgun, Arzu Kalayci, Alev Kılıcgedik, Onur Tasar, Sedat Kalkan, Ayhan Erkol, Akin İzgi, Ali Metin Esen & Cevat Kirma

  2. Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy

    Gonenc Kocabay

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  1. Can Yucel Karabay
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  3. Ahmet Guler
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Correspondence to Can Yucel Karabay.

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Karabay, C.Y., Kocabay, G., Guler, A. et al. Predictors of coronary artery aneurysm after stent implantation in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. Int J Cardiovasc Imaging 30, 1435–1444 (2014). https://doi.org/10.1007/s10554-014-0503-z

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  • DOI: https://doi.org/10.1007/s10554-014-0503-z

Keywords

  • Coronary artery aneurysm
  • Stent
  • ST-segment elevation acute myocardial infarction
  • Primary percutaneous coronary intervention
  • Coronary angiography
  • Inflammation