Assessment of silent brain injury in patients undergoing elective percutaneous coronary intervention due to chronic total occlusion


Uyanik M., Yıldırım U., Avcı B., Soylu K.

SCANDINAVIAN CARDIOVASCULAR JOURNAL, cilt.57, sa.1, ss.25-30, 2023 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 57 Sayı: 1
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1080/14017431.2022.2150786
  • Dergi Adı: SCANDINAVIAN CARDIOVASCULAR JOURNAL
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.25-30
  • Anahtar Kelimeler: Neuron-specific enolase, chronic total occlusion, silent brain infarct, coronary intervention, cerebral infarct, stroke, NEURON-SPECIFIC ENOLASE, ACUTE ISCHEMIC-STROKE, ASCENDING AORTA, INFARCTION, RISK, CATHETERIZATION, ANGIOGRAPHY, PREVALENCE, SEVERITY, REGISTRY
  • Ondokuz Mayıs Üniversitesi Adresli: Evet

Özet

Objective: Silent brain infarcts (SBI) are thromboembolic complications associated with cardiac surgery, diagnostic angiography, and percutaneous interventions. Serum neuron-specific enolase (NSE) is the proven biomarker for measuring neuronal damage. This study aimed to evaluate the incidence of SBI, defined as elevated NSE after coronary chronic total occlusion (CTO) intervention and elective coronary stenting. Design: The study population consisted of two patient groups: the CTO group included consecutive patients with coronary CTO intervention, and the control group consisted of patients who underwent elective coronary intervention. NSE blood levels were measured before and 12-18 h after the procedure. NSE blood levels of >20 ng/mL were considered SBI. Results: A total of 108 patients were included in the study. Of these, 55 (50.9%) had SBI after the procedure. The SBI rate was 59.7% in the CTO group and 39.1% in the control group. Patients with SBI were more likely to have diabetes mellitus, hyperlipidemia, higher HbA1c, higher total stent length, and longer procedural time. Multivariate logistic regression analysis showed that CTO procedure (odds ratio [OR]: 3.129; 95% confidence interval [CI]: 1.246-7.858; p < 0.015) and diabetes mellitus (OR: 2.93; 95% CI: 1.185-7.291; p < 0.020) are independent predictors of SBI. Conclusion: Our data suggest that SBI occurs more frequently after CTO intervention than after non-CTO intervention. Intervention complexity and patient clinical characteristics may explain the increased incidence.