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OP-90 Increased Serum Lipid Levels on Admission is Associated with Periprocedural Myocardial Injury Following Elective Percutaneous Coronary Intervention
MARCH 26e29, 2015
O R A L
Percutaneous Coronary Interventions: Novel Procedural Techniques and Outcomes Friday, March 27, 2015
A B S T R A C T S
15:30 PM w 17:00 PM, Hall 7 (Abstract nos. OP-090 w OP-096) - OP-90 Increased Serum Lipid Levels on Admission is Associated with Periprocedural Myocardial Injury Following Elective Percutaneous Coronary Intervention. Ali Buturak1, Aleks Degirmencioglu1, Mehmet Erturk2, Huseyin Karakurt2, Ali Rıza Demir2, Ozgur Surgit2, Hamdi Pusuroglu2, Mustafa Serteser3, Tugrul Norgaz1, Sevket Gorgulu1. 1 Department of Cardiology, Acıbadem Univeristy, Istanbul, Turkey; 2Department of Cardiology, Mehmet Akif Ersoy Cardiovascular Surgery Training and Research Center, Istanbul, Turkey; 3Department of Medical Biochemistry, Acıbadem Univeristy, Istanbul, Turkey. Objectives: We aimed to evaluate the correlation between the preprocedural serum lipid levels and the extent of periprocedural myocardial injury (PMI) in patients undergoing elective percutaneous coronary intervention (PCI). Background: PMI is accepted as a predictor of in-hospital cardiac events and long term adverse outcomes following PCI. Methods: The study group consisted of 195 patients (60.10.7 years old; 68 female and 127 males) undergoing elective PCI. Serum hscTnT concentrations were measured in blood samples obtained immediately before PCI and 12 hours after PCI. Serum total cholesterol (TC), low density lipoprotein- cholesterol (LDL-C), high density lipoproteincholesterol (HDL-C) and triglyceride (TG) levels were determined immediately before PCI. Results: The average pre-procedural hscTnT concentration was 8.10.2 ng/L. The average serum hscTnT concentration elevated to 34.12.8 ng/L (p<0.001) 12-hours after PCI. Post-procedural hscTnT concentrations were positively correlated to serum concentrations of TC (r¼0.435; p<0.001), LDL-C (r¼0.349; p<0.001) and TG (r¼0.517; p<0.001). Post-procedural hscTnT concentrations were significantly higher in patients with high serum TC (200 mg/dL), LDL-C (100 mg/dL) and TG (150 mg/dL) than the values observed for patients with normal serum concentrations of these lipid parameters. PMI and type 4a MI were observed in 95 (48.7%) and 27(13.9%) patients, respectively. The patients with type 4a MI had high serum TC (p<0.001), LDL-C (p<0.001) and TG (p<0.001) concentrations. Conclusions: Our findings clearly show that high serum levels of pre-procedural TC, LDL-C and TG are associated with significant elevations of hscTnT reflecting severe peri-procedural myocardial injury. These findings lead to the clinical implication that improving pre-procedural serum lipid status of patients could have beneficial effects for decreasing myocardial injury during PCI. Initiating statin treatment in patients who will undergo elective PCI could reduce periprocedural myocardial injury by not only inducing anti-inflammatory and plaque stabilizing effects but also improving serum lipid status of patients.
Figure. Correlations of the serum post-procedural hscTnT concentrations to the serum preprocedural concentrations of TC (A), LDL-C (B), HDL-C (C) and TG (D).
- OP-91 Transradial Catheterization Decreases the Radial Artery Luminal Diameter and Impairs Vasodilatation Response at the Access Site Late after the Intervention: an Observational Study. Ali Buturak1, Burak Murat Tekturk2, Aleks Degirmencioglu1, Ozden Sila Ulus3, Ozgur Surgit4, Cem Ariturk5, Ertugrul Zencirci6, Sevket Gorgulu1. 1Department of Cardiology, Acıbadem University, Istanbul, Turkey; 2Department of Radiology, Acıbadem Kadıkoy Hospital, Istanbul, Turkey; 3Department of Radiology, Acıbadem University, Istanbul, Turkey; 4Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey; 5Department of Cardiovascular Surgery, Acıbadem University, Istanbul, Turkey; 6 Department of Cardiology, Acıbadem Maslak Hospital, Istanbul, Turkey. Objectives: The present study aimed to evaluate the late term changes in radial artery luminal diameter (RAD) and vasodilatation response following transradial coronary intervention (TRI). Background: TRI inducing a trauma to radial artery intima may trigger chronic phase vascular changes and lead to anatomical and functional impairment. There is controversial data whether the impairment persists or repairs later. Methods: Fifty six consecutive patients undergoing TRI were enrolled prospectively. Baseline luminal diameter, flow associated dilatation (FAD) and nitroglycerin mediated dilatation (NMD) of the radial artery at the access site were measured before TRI by using high resolution ultrasound. Six months later; RAD, FAD and NMD were measured again at the same access site. Results: RAD at the sixth month was reduced compared with preprocedural measurements (2.74 0.42 mm vs 2.85 0.44 mm, p¼ 0.0001).The average FAD decreased to 5.66 5.87 %, which was significantly lower than the observed pre-procedural FAD (9.45 5.01 %) six months after TRI (p¼0.0001). Likewise, the average NMD at the sixth month was reduced compared with pre-procedural NMD (6.64
S40 The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
O R A L
Percutaneous Coronary Interventions: Novel Procedural Techniques and Outcomes Friday, March 27, 2015
A B S T R A C T S
15:30 PM w 17:00 PM, Hall 7 (Abstract nos. OP-090 w OP-096) - OP-90 Increased Serum Lipid Levels on Admission is Associated with Periprocedural Myocardial Injury Following Elective Percutaneous Coronary Intervention. Ali Buturak1, Aleks Degirmencioglu1, Mehmet Erturk2, Huseyin Karakurt2, Ali Rıza Demir2, Ozgur Surgit2, Hamdi Pusuroglu2, Mustafa Serteser3, Tugrul Norgaz1, Sevket Gorgulu1. 1 Department of Cardiology, Acıbadem Univeristy, Istanbul, Turkey; 2Department of Cardiology, Mehmet Akif Ersoy Cardiovascular Surgery Training and Research Center, Istanbul, Turkey; 3Department of Medical Biochemistry, Acıbadem Univeristy, Istanbul, Turkey. Objectives: We aimed to evaluate the correlation between the preprocedural serum lipid levels and the extent of periprocedural myocardial injury (PMI) in patients undergoing elective percutaneous coronary intervention (PCI). Background: PMI is accepted as a predictor of in-hospital cardiac events and long term adverse outcomes following PCI. Methods: The study group consisted of 195 patients (60.10.7 years old; 68 female and 127 males) undergoing elective PCI. Serum hscTnT concentrations were measured in blood samples obtained immediately before PCI and 12 hours after PCI. Serum total cholesterol (TC), low density lipoprotein- cholesterol (LDL-C), high density lipoproteincholesterol (HDL-C) and triglyceride (TG) levels were determined immediately before PCI. Results: The average pre-procedural hscTnT concentration was 8.10.2 ng/L. The average serum hscTnT concentration elevated to 34.12.8 ng/L (p<0.001) 12-hours after PCI. Post-procedural hscTnT concentrations were positively correlated to serum concentrations of TC (r¼0.435; p<0.001), LDL-C (r¼0.349; p<0.001) and TG (r¼0.517; p<0.001). Post-procedural hscTnT concentrations were significantly higher in patients with high serum TC (200 mg/dL), LDL-C (100 mg/dL) and TG (150 mg/dL) than the values observed for patients with normal serum concentrations of these lipid parameters. PMI and type 4a MI were observed in 95 (48.7%) and 27(13.9%) patients, respectively. The patients with type 4a MI had high serum TC (p<0.001), LDL-C (p<0.001) and TG (p<0.001) concentrations. Conclusions: Our findings clearly show that high serum levels of pre-procedural TC, LDL-C and TG are associated with significant elevations of hscTnT reflecting severe peri-procedural myocardial injury. These findings lead to the clinical implication that improving pre-procedural serum lipid status of patients could have beneficial effects for decreasing myocardial injury during PCI. Initiating statin treatment in patients who will undergo elective PCI could reduce periprocedural myocardial injury by not only inducing anti-inflammatory and plaque stabilizing effects but also improving serum lipid status of patients.
Figure. Correlations of the serum post-procedural hscTnT concentrations to the serum preprocedural concentrations of TC (A), LDL-C (B), HDL-C (C) and TG (D).
- OP-91 Transradial Catheterization Decreases the Radial Artery Luminal Diameter and Impairs Vasodilatation Response at the Access Site Late after the Intervention: an Observational Study. Ali Buturak1, Burak Murat Tekturk2, Aleks Degirmencioglu1, Ozden Sila Ulus3, Ozgur Surgit4, Cem Ariturk5, Ertugrul Zencirci6, Sevket Gorgulu1. 1Department of Cardiology, Acıbadem University, Istanbul, Turkey; 2Department of Radiology, Acıbadem Kadıkoy Hospital, Istanbul, Turkey; 3Department of Radiology, Acıbadem University, Istanbul, Turkey; 4Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey; 5Department of Cardiovascular Surgery, Acıbadem University, Istanbul, Turkey; 6 Department of Cardiology, Acıbadem Maslak Hospital, Istanbul, Turkey. Objectives: The present study aimed to evaluate the late term changes in radial artery luminal diameter (RAD) and vasodilatation response following transradial coronary intervention (TRI). Background: TRI inducing a trauma to radial artery intima may trigger chronic phase vascular changes and lead to anatomical and functional impairment. There is controversial data whether the impairment persists or repairs later. Methods: Fifty six consecutive patients undergoing TRI were enrolled prospectively. Baseline luminal diameter, flow associated dilatation (FAD) and nitroglycerin mediated dilatation (NMD) of the radial artery at the access site were measured before TRI by using high resolution ultrasound. Six months later; RAD, FAD and NMD were measured again at the same access site. Results: RAD at the sixth month was reduced compared with preprocedural measurements (2.74 0.42 mm vs 2.85 0.44 mm, p¼ 0.0001).The average FAD decreased to 5.66 5.87 %, which was significantly lower than the observed pre-procedural FAD (9.45 5.01 %) six months after TRI (p¼0.0001). Likewise, the average NMD at the sixth month was reduced compared with pre-procedural NMD (6.64
S40 The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral