Background: To investigate the incidence and associated factors for enzyme release following percutaneous coronary intervention comparing assessment with creatine kinase NIB (CK-MB) and troponin T (TnT).Method: TnT and CK-MB were measured post procedure in a consecutive series of 933 patients undergoing elective percutaneous coronary intervention between 1/4/2003 and 1/5/2004 at a single regional cardiac centre.Results: CK-MB level significantly correlated to TnT levels (R=0.747, p < 0.001) and a CK-MB level of above 3 times the upper limit of the local reference range (> 3 x ULN) was predicted with 95% sensitivity (48% specificity) at a TnT level of 0.11. Multivariate predictors of > 3 x ULN CK-MB release for uncomplicated percutaneous coronary intervention (n=898) were multi-vessel angioplasty (OR=2.51, 95% CI = 1.57 to 4.01; p < 0.001), saphenous venous graft angioplasty (OR=5.5, 95% CI = 1.94 to 13.00; p=0.005) and lack of Clopidogrel preloading (OR=2.02, 95% CI = 1.30 to 4.38; p=0.027).Conclusions: TnT was found to be a sensitive although not a highly specific marker of CK-MB release. In this study a TnT level above a threshold of 0.11 would identify 95% of the prognostically important 3-fold CK-MB releases. Replacing the > 3 x ULN CK-MB threshold with a TnT level of 0.1 ng/l following percutancous coronary intervention would increase the apparent rate of myocardial infarction from 11% to 20%.Lack of Clopidogrel preloading was independently associated with a > 3 x ULN CK-MB release following uncomplicated elective percutaneous coronary intervention. (c) 2006 Elsevier Ireland Ltd. All rights reserved.

This study was performed to assess the possibility that patient age may independently affect improvements in health-related quality of life following percutaneous coronary intervention. One hundred five patients undergoing elective percutaneous coronary intervention at a single tertiary referral center between January 10, 2001 and January 6, 2002 were enrolled and prospectively evaluated. Health-related quality of life was assessed before and 1 year following percutaneous coronary intervention using Short Form-12 and the Seattle Angina Questionnaire. For the purpose of analysis, patients were divided according to age (younger than 60, 60-70, and older than 70 years). One hundred patients (95%) completed both questionnaires. Baseline characteristics among the age groups were similar in terms of gender, cardiac risk factors, and procedural details. All health-related quality-of-life indices demonstrated improvements with at least four variables in each group achieving a clinically significant increase (>20%). At least eight modalities in each group achieved statistical significance (p=0.01). With the exception of physical functioning, the improvements in health-related quality of life were not significantly different among age groups.

BACKGROUND: Coronary artery stenting is particularly useful during percutaneous coronary intervention for long lesions previously associated with a low procedural success rate and a high complication rate of dissection and occlusion. Current treatment options include implantation of a single long stent, multiple contiguous stents, or 'spot' stenting. However, multiple stent implantation may result in sections of overlapping stent or gaps of unstented segments and is an independent predictor of restenosis. The early and intermediate clinical outcome of single and multiple long stent (>/= 30 mm) implantation is not established. METHODS AND RESULTS: The authors retrospectively identified 123 consecutive patients who had undergone stenting using one or more long coronary stents. Baseline clinical data, procedural outcomes and completed clinical follow-up to 52 weeks were obtained by case-note review. The majority (69%) required intervention for stable coronary disease. Seventy-seven per cent of lesions were either type B2 or C and only 2% were in saphenous vein grafts. The procedural success rate was 94%. A total of 15 major events occurred in 13 patients (11%). Ten acute events occurred and five events were during the follow-up period from 30 days to 52 weeks. Two patients died, one from uncontrolled bleeding secondary to the use of antithrombotic agents and one at four weeks due to sudden death. One patient had a postprocedural infarct. Two patients required in-hospital repeat revascularization for acute vessel closure and eight required revascularization during follow-up (three cases of occlusion/thrombosis and five cases of restenosis). CONCLUSIONS: The use of long coronary stents (>/= 30 mm) for the treatment of long diffuse native vessel disease, saphenous vein graft disease and long coronary dissections is associated with a reasonable procedural success rate and acceptable early and intermediate-term clinical outcomes.