Myocardial infarction as a presentation of clinical in-stent restenosis

Atasu K. Nayak, Akio Kawamura, Richard W. Nesto, Gershan Davis, Jennifer Jarbeau, Christopher T. Pyne, David E. Gossman, Thomas C. Piemonte, Nabila Riskalla, Manish S. Chauhan

Research output: Contribution to journalArticle

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Abstract

Background: In-stent restenosis is considered to be a gradual and progressive condition and there is scant data on myocardial infarction (MI) as a clinical presentation. Methods and Results: Of 2,462 consecutive patients who underwent percutaneous coronary intervention between June 2001 and December 2002, clinical in-stent restenosis occurred in 212 (8.6%), who were classified into 3 groups: ST elevation MI (STEMI), non-ST elevation MI (NSTEMI) and non-MI. Of the 212 patients presenting with clinical in-stent restenosis, 22 (10.4%) had MI (creatine kinase (CK) ≥2xbaseline with elevated CKMB). The remaining 190 (89.6%) patients had stable angina or evidence of ischemia by stress test without elevation of cardiac enzymes. Median interval between previous intervention and presentation for clinical instent restenosis was shorter for patients with MI than for non-MI patients (STEMI, 90 days; NSTEMI, 79 days; non-MI, 125 days; p=0.07). Diffuse in-stent restenosis was more frequent in MI patients than in non-MI patients (72.7% vs 56.3%; p<0.005). Renal failure was more prevalent in patients with MI than in those without MI (31.8% vs 6.3%, p=0.001). Compared with the non-MI group, patients with MI were more likely to have acute coronary syndromes at the time of index procedure (81.8% vs 56.8%, p=0.02). Conclusion: Clinical in-stent restenosis can frequently present as MI and such patients are more likely to have an aggressive angiographic pattern of restenosis. Renal failure and acute coronary syndromes at the initial procedure are associated with MI.

Original languageEnglish
Pages (from-to)1026-1029
Number of pages4
JournalCirculation Journal
Volume70
Issue number8
DOIs
Publication statusPublished - 2006

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Stents
Myocardial Infarction
Infarction
Acute Coronary Syndrome
Renal Insufficiency
MB Form Creatine Kinase
Stable Angina
Percutaneous Coronary Intervention
Exercise Test
Ischemia
Enzymes

Keywords

  • Angiography
  • Angioplasty
  • Restenosis
  • Stents
  • Thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Nayak, A. K., Kawamura, A., Nesto, R. W., Davis, G., Jarbeau, J., Pyne, C. T., ... Chauhan, M. S. (2006). Myocardial infarction as a presentation of clinical in-stent restenosis. Circulation Journal, 70(8), 1026-1029. https://doi.org/10.1253/circj.70.1026

Myocardial infarction as a presentation of clinical in-stent restenosis. / Nayak, Atasu K.; Kawamura, Akio; Nesto, Richard W.; Davis, Gershan; Jarbeau, Jennifer; Pyne, Christopher T.; Gossman, David E.; Piemonte, Thomas C.; Riskalla, Nabila; Chauhan, Manish S.

In: Circulation Journal, Vol. 70, No. 8, 2006, p. 1026-1029.

Research output: Contribution to journalArticle

Nayak, AK, Kawamura, A, Nesto, RW, Davis, G, Jarbeau, J, Pyne, CT, Gossman, DE, Piemonte, TC, Riskalla, N & Chauhan, MS 2006, 'Myocardial infarction as a presentation of clinical in-stent restenosis', Circulation Journal, vol. 70, no. 8, pp. 1026-1029. https://doi.org/10.1253/circj.70.1026
Nayak AK, Kawamura A, Nesto RW, Davis G, Jarbeau J, Pyne CT et al. Myocardial infarction as a presentation of clinical in-stent restenosis. Circulation Journal. 2006;70(8):1026-1029. https://doi.org/10.1253/circj.70.1026
Nayak, Atasu K. ; Kawamura, Akio ; Nesto, Richard W. ; Davis, Gershan ; Jarbeau, Jennifer ; Pyne, Christopher T. ; Gossman, David E. ; Piemonte, Thomas C. ; Riskalla, Nabila ; Chauhan, Manish S. / Myocardial infarction as a presentation of clinical in-stent restenosis. In: Circulation Journal. 2006 ; Vol. 70, No. 8. pp. 1026-1029.
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abstract = "Background: In-stent restenosis is considered to be a gradual and progressive condition and there is scant data on myocardial infarction (MI) as a clinical presentation. Methods and Results: Of 2,462 consecutive patients who underwent percutaneous coronary intervention between June 2001 and December 2002, clinical in-stent restenosis occurred in 212 (8.6{\%}), who were classified into 3 groups: ST elevation MI (STEMI), non-ST elevation MI (NSTEMI) and non-MI. Of the 212 patients presenting with clinical in-stent restenosis, 22 (10.4{\%}) had MI (creatine kinase (CK) ≥2xbaseline with elevated CKMB). The remaining 190 (89.6{\%}) patients had stable angina or evidence of ischemia by stress test without elevation of cardiac enzymes. Median interval between previous intervention and presentation for clinical instent restenosis was shorter for patients with MI than for non-MI patients (STEMI, 90 days; NSTEMI, 79 days; non-MI, 125 days; p=0.07). Diffuse in-stent restenosis was more frequent in MI patients than in non-MI patients (72.7{\%} vs 56.3{\%}; p<0.005). Renal failure was more prevalent in patients with MI than in those without MI (31.8{\%} vs 6.3{\%}, p=0.001). Compared with the non-MI group, patients with MI were more likely to have acute coronary syndromes at the time of index procedure (81.8{\%} vs 56.8{\%}, p=0.02). Conclusion: Clinical in-stent restenosis can frequently present as MI and such patients are more likely to have an aggressive angiographic pattern of restenosis. Renal failure and acute coronary syndromes at the initial procedure are associated with MI.",
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AU - Nesto, Richard W.

AU - Davis, Gershan

AU - Jarbeau, Jennifer

AU - Pyne, Christopher T.

AU - Gossman, David E.

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N2 - Background: In-stent restenosis is considered to be a gradual and progressive condition and there is scant data on myocardial infarction (MI) as a clinical presentation. Methods and Results: Of 2,462 consecutive patients who underwent percutaneous coronary intervention between June 2001 and December 2002, clinical in-stent restenosis occurred in 212 (8.6%), who were classified into 3 groups: ST elevation MI (STEMI), non-ST elevation MI (NSTEMI) and non-MI. Of the 212 patients presenting with clinical in-stent restenosis, 22 (10.4%) had MI (creatine kinase (CK) ≥2xbaseline with elevated CKMB). The remaining 190 (89.6%) patients had stable angina or evidence of ischemia by stress test without elevation of cardiac enzymes. Median interval between previous intervention and presentation for clinical instent restenosis was shorter for patients with MI than for non-MI patients (STEMI, 90 days; NSTEMI, 79 days; non-MI, 125 days; p=0.07). Diffuse in-stent restenosis was more frequent in MI patients than in non-MI patients (72.7% vs 56.3%; p<0.005). Renal failure was more prevalent in patients with MI than in those without MI (31.8% vs 6.3%, p=0.001). Compared with the non-MI group, patients with MI were more likely to have acute coronary syndromes at the time of index procedure (81.8% vs 56.8%, p=0.02). Conclusion: Clinical in-stent restenosis can frequently present as MI and such patients are more likely to have an aggressive angiographic pattern of restenosis. Renal failure and acute coronary syndromes at the initial procedure are associated with MI.

AB - Background: In-stent restenosis is considered to be a gradual and progressive condition and there is scant data on myocardial infarction (MI) as a clinical presentation. Methods and Results: Of 2,462 consecutive patients who underwent percutaneous coronary intervention between June 2001 and December 2002, clinical in-stent restenosis occurred in 212 (8.6%), who were classified into 3 groups: ST elevation MI (STEMI), non-ST elevation MI (NSTEMI) and non-MI. Of the 212 patients presenting with clinical in-stent restenosis, 22 (10.4%) had MI (creatine kinase (CK) ≥2xbaseline with elevated CKMB). The remaining 190 (89.6%) patients had stable angina or evidence of ischemia by stress test without elevation of cardiac enzymes. Median interval between previous intervention and presentation for clinical instent restenosis was shorter for patients with MI than for non-MI patients (STEMI, 90 days; NSTEMI, 79 days; non-MI, 125 days; p=0.07). Diffuse in-stent restenosis was more frequent in MI patients than in non-MI patients (72.7% vs 56.3%; p<0.005). Renal failure was more prevalent in patients with MI than in those without MI (31.8% vs 6.3%, p=0.001). Compared with the non-MI group, patients with MI were more likely to have acute coronary syndromes at the time of index procedure (81.8% vs 56.8%, p=0.02). Conclusion: Clinical in-stent restenosis can frequently present as MI and such patients are more likely to have an aggressive angiographic pattern of restenosis. Renal failure and acute coronary syndromes at the initial procedure are associated with MI.

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KW - Angioplasty

KW - Restenosis

KW - Stents

KW - Thrombosis

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