Myonecrosis following stent placement: association between impaired TIMI myocardial perfusion grade and MRI visualization of microinfarction.

Published

Journal Article

Contrast-enhanced cardiac MRI (ceMRI) and TIMI myocardial perfusion grade analysis (TMPG) are proven methods for visualization of microinfarction and assessment of microvascular perfusion, respectively. To determine whether microvascular obstruction accounts for procedure-related myonecrosis, 14 poststent patients, 9 with procedural CK-MB elevation and 5 controls, underwent ceMRI and TMPG. All had TIMI 3 flow pre- and poststent. TMPG was normal in 12/14 pre- and 7/14 poststent. Those with poststent decline in TMPG had higher CK-MB (median, 41.0 vs. 7.4 ng/mL; P = 0.01) and larger infarct mass (median, 3.1 vs. 0.89 g; P = 0.04). More extensive myonecrosis (CK-MB > 3 x normal; infarct mass > 3 g) was observed more frequently if there was a poststent decline in TMPG (3/3, 100%, vs. 2/11, 18.2%; P = 0.03). These data support the theory that distal embolization and microvascular obstruction are associated with myonecrosis following otherwise successful coronary stent placement and provide further insight into its pathophysiology.

Full Text

Duke Authors

Cited Authors

  • Choi, JW; Gibson, CM; Murphy, SA; Davidson, CJ; Kim, RJ; Ricciardi, MJ

Published Date

  • April 2004

Published In

Volume / Issue

  • 61 / 4

Start / End Page

  • 472 - 476

PubMed ID

  • 15065140

Pubmed Central ID

  • 15065140

International Standard Serial Number (ISSN)

  • 1522-1946

Digital Object Identifier (DOI)

  • 10.1002/ccd.20024

Language

  • eng

Conference Location

  • United States