Abstract
Angiopoietin-2 (Ang-2) is a proangiogenic factor that mediates inflammation and atherosclerosis. We evaluated the predictive value of circulating Ang-2 levels for periprocedural myocardial injury (PMI) in 145 patients undergoing elective percutaneous coronary intervention (PCI), and investigated whether post-PCI Ang-2 levels are influenced by PMI. PMI was defined as a post-procedural troponin elevation above the 5×99th percentile upper reference limit. Blood samples for Ang-2 analysis were collected at admission and on postoperative days 1 and 3. PMI occurred in 40 patients (28%). At baseline, there was no difference in Ang-2 levels between PMI and non-PMI patients (P=0.554). However, a significant interaction effect between PMI occurrence and time on Ang-2 levels was observed (interaction P=0.036). Although serum Ang-2 levels in non-PMI patients gradually decreased, Ang-2 levels in PMI patients did not change between different time-points. Multiple logistic regression analysis revealed that age, total stent length, and serum levels of N-terminal pro-brain natriuretic peptide were independent PMI predictors. These findings indicate that pre-procedural Ang-2 levels do not impact PMI occurrence after elective PCI. However, changes in Ang-2 levels after the procedure are closely related to PMI.
Highlights
Percutaneous coronary intervention (PCI) has become an effective and safe method for revascularization in patients with coronary artery disease (CAD), especially in an elective setting [1]
From 145 patients who underwent elective PCI, periprocedural myocardial injury (PMI) occurred in 40 patients (28%)
After PCI, high-sensitivity troponin T (hsTnT) was higher in PMI patients than in non-PMI patients, while there was no significant difference in serum creatinine (Table 1)
Summary
Percutaneous coronary intervention (PCI) has become an effective and safe method for revascularization in patients with coronary artery disease (CAD), especially in an elective setting [1]. PMI is frequently attributed to myocardial damage via distal embolization, side-branch occlusion, and other unexpected procedural complications. PMI is most likely to occur in www.aging-us.com patients with advanced lesions, complex anatomy, and difficult procedures [5]. As an important proangiogenic factor, Ang-2 has been recently implicated in mediating inflammation [10,11,12] and atherosclerosis [13, 14]. Ang-2 is abundantly expressed in advanced human atherosclerotic lesions, and is associated with microvessel density [15, 16]. In patients with CAD, especially acute myocardial infarction (AMI), the circulating Ang-2 levels are significantly increased [17]
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