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Incidence and Potential Mechanism(s) of Post-Procedural Rise of Cardiac Biomarker in Patients With Coronary Artery Narrowing After Implantation of an Everolimus-Eluting Bioresorbable Vascular Scaffold or Everolimus-Eluting Metallic Stent

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Affiliated Author(s)
조윤경
Alternative Author(s)
Cho, Yun Kyeong
Journal Title
JACC Cardiovascular Interventions.
ISSN
1936-8798
Issued Date
2015
Keyword
Bioresorbable scaffoldCardiac biomarkerDevice overlapPeriprocedural myocardial infarction
Abstract
OBJECTIVES This study sought to evaluate the mechanism of post-procedural cardiac biomarker (CB) rise following
device implantation.
BACKGROUND A fully bioresorbable Absorb scaffold, compared with everolimus-eluting metallic stents (EES),
might be associated with a higher incidence of periprocedural myocardial injury.
METHODS In 501 patients with stable or unstable angina randomized to either Absorb (335 patients) or EES (n ¼ 166) in
the ABSORB II trial, 3 types of CB (creatine kinase, creatine kinase-myocardial band, and troponin) were obtained before
and after procedure. Per protocol, periprocedural myocardial infarction (PMI) was defined as creatine kinase rise >2 the
upper limit of normal with creatine kinase-myocardial band rise.
RESULTS Incidence of side branch occlusion and any anatomic complications assessed by angiography was
similar between the 2 treatment arms (side branch occlusion: Absorb: 5.3% vs. Xience: 7.6%, p ¼ 0.07; any
anatomic complication: Absorb: 16.4% vs. EES: 19.9%, p ¼ 0.39). Fourteen patients who presented with
recent myocardial infarction at entry with normalized creatine kinase-myocardial band according to the protocol
were excluded for post-CB analysis. The overall compliance for CB was 97.8%. The CB rise subcategorized in
7 different ranges was comparable between the 2 treatment arms. PMI rate was numerically higher in the
Absorb arm according to the per-protocol definitions, and treatment with overlapping devices was the only
independent determinant of per-protocol PMI (odds ratio: 5.07, 95% confidence interval: 1.78 to 14.41,
p ¼ 0.002).
CONCLUSIONS There were no differences in the incidence of CB rise and PMI between Absorb and EES. Device overlap
might be a precipitating factor of myocardial injury. (ABSORB II Randomized Clinical Trial: A Clinical Evaluation to
Compare the Safety, Efficacy, and Performance of Absorb Everolimus Eluting Bioresorbable Vascular Scaffold System
Against Xience Everolimus Eluting Coronary Stent System in the Treatment of Subjects With Ischemic Heart Disease
Caused by De Novo Native Coronary Artery Lesions.
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine
Citation
Yuki Ishibashi et al. (2015). Incidence and Potential Mechanism(s) of Post-Procedural Rise of Cardiac Biomarker in Patients With Coronary Artery Narrowing After Implantation of an Everolimus-Eluting Bioresorbable Vascular Scaffold or Everolimus-Eluting Metallic Stent. JACC Cardiovascular Interventions., 8(8), 1053–1063. doi: 10.1016/j.jcin.2015.06.001
Type
Article
ISSN
1936-8798
DOI
10.1016/j.jcin.2015.06.001
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32979
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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