The influence of periprocedural ischemia on coronary artery bifurcation stenting (PCI) remains un... more The influence of periprocedural ischemia on coronary artery bifurcation stenting (PCI) remains uncertain. The objective is to determine the differences in rates of end procedural ischemia after bifurcation lesion PCI detected with intracoronary electrocardiography (icECG). Unipolar icECGs were recorded before, during and after stent placement and at the end of procedure in side branch (SB) and main branch (MB). The coronary wire was placed in all distal vessels with diameter > 1.5mm, to "map" the distal zones of ischemia. The patient population consisted of patients with stable/unstable angina with troponin I evaluated before and after PCI. We studied 147 patients (68% males) with mean age of 64±9 years. One hundred forty two patients had icECG recordings at the end of PCI from all locations of treated region with 36% of patients had main branch ST segment elevation (STE) and 31% had icECG STE in SB region (p = 0.378). The icECG had sensitivity of 82%, specificity of 81% to detect troponin I elevation, with positive predictive value of 81% and negative predictive value of 83%. The independent predictors of troponin increase (>5xN) were: sex (for female gender, OR = 0.130, CI 0.017 - 0.995, p = 0.049), previous myocardial infarction (OR = 33.23, CI 2.802 - 394.1, p = 0.005) and icECG STE in MB or SB or occlusion of secondary SB (OR = 7.877, CI = 2.474-25.07, p <0.001) and for any troponin elevation were double product - SBPxHR (OR = 0.999, CI = 0.999-1.00, p = 0.022) and icECG STE in MB or SB or occlusion of secondary SB (OR = 9.762, CI = 3.273-29.12, p <0.001). The icECG is highly sensitive and specific method for determination of ischemic regions and prediction of elevated Troponin I.
The influence of periprocedural ischemia on coronary artery bifurcation stenting (PCI) remains un... more The influence of periprocedural ischemia on coronary artery bifurcation stenting (PCI) remains uncertain. The objective is to determine the differences in rates of end procedural ischemia after bifurcation lesion PCI detected with intracoronary electrocardiography (icECG). Unipolar icECGs were recorded before, during and after stent placement and at the end of procedure in side branch (SB) and main branch (MB). The coronary wire was placed in all distal vessels with diameter > 1.5mm, to "map" the distal zones of ischemia. The patient population consisted of patients with stable/unstable angina with troponin I evaluated before and after PCI. We studied 147 patients (68% males) with mean age of 64±9 years. One hundred forty two patients had icECG recordings at the end of PCI from all locations of treated region with 36% of patients had main branch ST segment elevation (STE) and 31% had icECG STE in SB region (p = 0.378). The icECG had sensitivity of 82%, specificity of 81% to detect troponin I elevation, with positive predictive value of 81% and negative predictive value of 83%. The independent predictors of troponin increase (>5xN) were: sex (for female gender, OR = 0.130, CI 0.017 - 0.995, p = 0.049), previous myocardial infarction (OR = 33.23, CI 2.802 - 394.1, p = 0.005) and icECG STE in MB or SB or occlusion of secondary SB (OR = 7.877, CI = 2.474-25.07, p <0.001) and for any troponin elevation were double product - SBPxHR (OR = 0.999, CI = 0.999-1.00, p = 0.022) and icECG STE in MB or SB or occlusion of secondary SB (OR = 9.762, CI = 3.273-29.12, p <0.001). The icECG is highly sensitive and specific method for determination of ischemic regions and prediction of elevated Troponin I.
The influence of periprocedural ischemia on coronary artery bifurcation stenting (PCI) remains un... more The influence of periprocedural ischemia on coronary artery bifurcation stenting (PCI) remains uncertain. The objective is to determine the differences in rates of end procedural ischemia after bifurcation lesion PCI detected with intracoronary electrocardiography (icECG). Unipolar icECGs were recorded before, during and after stent placement and at the end of procedure in side branch (SB) and main branch (MB). The coronary wire was placed in all distal vessels with diameter > 1.5mm, to "map" the distal zones of ischemia. The patient population consisted of patients with stable/unstable angina with troponin I evaluated before and after PCI. We studied 147 patients (68% males) with mean age of 64±9 years. One hundred forty two patients had icECG recordings at the end of PCI from all locations of treated region with 36% of patients had main branch ST segment elevation (STE) and 31% had icECG STE in SB region (p = 0.378). The icECG had sensitivity of 82%, specificity of 81% to detect troponin I elevation, with positive predictive value of 81% and negative predictive value of 83%. The independent predictors of troponin increase (>5xN) were: sex (for female gender, OR = 0.130, CI 0.017 - 0.995, p = 0.049), previous myocardial infarction (OR = 33.23, CI 2.802 - 394.1, p = 0.005) and icECG STE in MB or SB or occlusion of secondary SB (OR = 7.877, CI = 2.474-25.07, p <0.001) and for any troponin elevation were double product - SBPxHR (OR = 0.999, CI = 0.999-1.00, p = 0.022) and icECG STE in MB or SB or occlusion of secondary SB (OR = 9.762, CI = 3.273-29.12, p <0.001). The icECG is highly sensitive and specific method for determination of ischemic regions and prediction of elevated Troponin I.
The influence of periprocedural ischemia on coronary artery bifurcation stenting (PCI) remains un... more The influence of periprocedural ischemia on coronary artery bifurcation stenting (PCI) remains uncertain. The objective is to determine the differences in rates of end procedural ischemia after bifurcation lesion PCI detected with intracoronary electrocardiography (icECG). Unipolar icECGs were recorded before, during and after stent placement and at the end of procedure in side branch (SB) and main branch (MB). The coronary wire was placed in all distal vessels with diameter > 1.5mm, to "map" the distal zones of ischemia. The patient population consisted of patients with stable/unstable angina with troponin I evaluated before and after PCI. We studied 147 patients (68% males) with mean age of 64±9 years. One hundred forty two patients had icECG recordings at the end of PCI from all locations of treated region with 36% of patients had main branch ST segment elevation (STE) and 31% had icECG STE in SB region (p = 0.378). The icECG had sensitivity of 82%, specificity of 81% to detect troponin I elevation, with positive predictive value of 81% and negative predictive value of 83%. The independent predictors of troponin increase (>5xN) were: sex (for female gender, OR = 0.130, CI 0.017 - 0.995, p = 0.049), previous myocardial infarction (OR = 33.23, CI 2.802 - 394.1, p = 0.005) and icECG STE in MB or SB or occlusion of secondary SB (OR = 7.877, CI = 2.474-25.07, p <0.001) and for any troponin elevation were double product - SBPxHR (OR = 0.999, CI = 0.999-1.00, p = 0.022) and icECG STE in MB or SB or occlusion of secondary SB (OR = 9.762, CI = 3.273-29.12, p <0.001). The icECG is highly sensitive and specific method for determination of ischemic regions and prediction of elevated Troponin I.
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