Author + information
- Received April 15, 2008
- Revision received July 16, 2008
- Accepted July 30, 2008
- Published online February 1, 2009.
- Tadayuki Uetani, MD, PhD⁎,⁎ (, )
- Tetsuya Amano, MD, PhD⁎,
- Soichiro Kumagai, MD⁎,
- Hirohiko Ando, MD⁎,
- Kiminobu Yokoi, MD⁎,
- Tomohiro Yoshida, MD⁎,
- Bunichi Kato, MD, PhD⁎,
- Masataka Kato, MD⁎,
- Nobuyuki Marui, MD, PhD⁎,
- Michio Nanki, MD, PhD⁎,
- Tatsuaki Matsubara, MD, PhD†,
- Hideki Ishii, MD, PhD‡,
- Hideo Izawa, MD, PhD‡ and
- Toyoaki Murohara, MD, PhD‡
- ↵⁎Reprint requests and correspondence:
Dr. Tadayuki Uetani, Department of Cardiology, Chubu Rosai Hospital, 1-10-6, Komei, Minato-ku, Nagoya, Japan
Objectives With an intracoronary electrocardiogram (IcECG) recording with insulated polymer-coated guidewire without balloon catheter, we sought to examine the association between ST-segment elevation in the IcECG after elective stenting and myocardial injury.
Background An IcECG is a sensitive method to detect local myocardial ischemia. Occasionally, persistent ST-segment elevation in the IcECG was recorded after successful coronary intervention. Conventionally IcECG was recorded with a guidewire and over-the-wire system.
Methods Patients who underwent elective stenting were enrolled (n = 339). The IcECG both at baseline and after procedure were obtained with a guidewire with an insulating coated shaft suitable for IcECG recording. The presence of chest pain after percutaneous coronary intervention was recorded. Cardiac biomarkers were examined 18 h after the procedure.
Results The ST-segment elevation in the IcECG after procedure was recorded in 65 patients, and no change was recorded in 274 patients. Troponin-T, creatine phosphokinase, and creatine kinase MB isoform after the procedure were significantly higher in patients with post-procedural ST-segment elevation in the IcECG than patients without ST-segment elevation. Multivariate analysis demonstrated that ST-segment elevation in the IcECG is an independent predictor of post-procedural myocardial injury. The incidence of ST-segment elevation in the IcECG was significantly higher in patients with post-procedural chest pain than patients without chest pain (p < 0.001).
Conclusions We demonstrated a facile method to record IcECG with a guidewire with a polymer-coated shaft. The IcECG is a useful method for predicting post-procedural myocardial injuries.
- Received April 15, 2008.
- Revision received July 16, 2008.
- Accepted July 30, 2008.
- American College of Cardiology Foundation