Skip to main content
SpringerLink
Log in

Predictors of coronary artery aneurysm after stent implantation in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

The clinical and angiographic predictors of coronary artery aneurysm (CAA) formation in patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) are not clear. This study aims to assess the predictors of CAA formation after primary PCI. 3,428 patients who underwent PCI for STEMI were enrolled. The average period of follow-up was mean 48 months (range 35–56 months) after PCI. During this time, 1,304 patients were underwent follow-up coronary angiography. CAA was detected in 21 patients (1.6 %). CAA occurred at the segment of stent implantation in all patients. The clinical and angiographic data were compared between patients with CAA group (n = 21) and without CAA group (n = 1,283). Patients who developed CAA had longer reperfusion time, higher high-sensitiviy C-reactive protein (hs-CRP) levels and neutrophil to lymphocyte ratio than those who had without CAA. Angiographically, CAA developed proximally located lesions and lesion length was significantly greater in patients with CAA than without CAA. Statin and beta-blocker discontinuation were found higher in stent-associated CAA. Every 1 mg/l increase in hs-CRP and implantation of drug eluting stent (DES) were independent predictor of CAA formation after STEMI. Baseline elevated inflammation status and DES implantation in the setting of STEMI may predict the CAA formation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Aoki J, Kirtane A, Leon MB, Dangas G (2008) Coronary artery aneurysms after drug-eluting stent implantation. JACC Cardiovasc Interv 1:14–21

    Article  PubMed  Google Scholar 

  2. Karabay CY, Kocabay G, Tasar O, Kalayci A, Guler A, Kirma C (2013) Evaluation of aneurysm after coronary stent implantation by optical coherence tomography. Kardiol Pol 71:659

    Article  PubMed  Google Scholar 

  3. Yoshikawa D, Ishii H, Aoyama Y, Ichimiya H, Shimizu Y, Isobe S et al (2010) Optical coherence tomography images of a coronary artery aneurysm in an infarct-related artery 6 months after bare-metal stent implantation. JACC Cardiovasc Interv 3:1300–1302

    Article  PubMed  Google Scholar 

  4. Bajaj S, Parikh R, Hamdan A, Bikkina M (2010) Covered-stent treatment of coronary aneurysm after drug-eluting stent placement: case report and literature review. Tex Heart Inst J 37:449–544

    PubMed Central  PubMed  Google Scholar 

  5. Slota PA, Fischman DL, Savage MP, Rake R, Goldberg S (1997) Frequency and outcome of development of coronary artery aneurysm after intracoronary stent placement and angioplasty. STRESS Trial Investigators. Am J Cardiol 79:1104–1106

    Article  CAS  PubMed  Google Scholar 

  6. Virmani R, Guagliumi G, Farb A, Musumeci G, Grieco N, Motta T et al (2004) Localized hypersensitivity and late coronary thrombosis secondary to a sirolimus-eluting stent: should we be cautious? Circulation 109:701–705

    Article  PubMed  Google Scholar 

  7. Lüscher TF, Steffel J, Eberli FR, Joner M, Nakazawa G, Tanner FC et al (2007) Drug-eluting stent and coronary thrombosis: biological mechanisms and clinical implications. Circulation 115:1051–1058

    Article  PubMed  Google Scholar 

  8. Ahn CM, Hong BK, Kim JY, Min PK, Yoon YW, Lee BK et al (2010) Incidence and natural history of coronary artery aneurysm developing after drug-eluting stent implantation. Am Heart J 160:987–994

    Article  PubMed  Google Scholar 

  9. Feng T, Yundai C, Hongbin L, Lian C, Zhijun S, Jun G et al (2013) Evaluation neointimal coverage in patients with coronary artery aneurysm formation after drug-eluting stent implantation by optical coherence tomography. Int J Cardiovasc Imaging 29:1677–1683

    Article  PubMed Central  PubMed  Google Scholar 

  10. Alfonso F, Pérez-Vizcayno MJ, Ruiz M, Suárez A, Cazares M, Hernández R et al (2009) Coronary aneurysms after drug-eluting stent implantation: clinical, angiographic, and intravascular ultrasound findings. J Am Coll Cardiol 53:2053–2060

    Article  CAS  PubMed  Google Scholar 

  11. Wang KY, Ting CT, St John Sutton M, Chen YT (1999) Coronary artery aneurysms: a 25-patient study. Catheter Cardiovasc Interv 48:31–38

    Article  CAS  PubMed  Google Scholar 

  12. Cockcroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16:31–41

    Article  CAS  PubMed  Google Scholar 

  13. Morrow DA, Antman EM, Charlesworth A et al (2000) TIMI risk score for ST-elevation myocardial infarction: a convenient, bedside, clinical score for risk assessment at presentation: An intravenous nPA for treatment of Infarcting Myocardium Early II trial substudy. Circulation 102:2031–2037

    Article  CAS  PubMed  Google Scholar 

  14. Wijns W, Kolh P, Danchin N, Di Mario C, Falk V, Folliguet T et al (2010) Guidelines on myocardial revascularization. Eur Heart J 31:2501–2555

    Article  PubMed  Google Scholar 

  15. Gibson CM, de Lemos JA, Murphy SA et al (2001) Combination therapy with abciximab reduces angiographically evident thrombus in acute myocardial infarction: a TIMI 14 substudy. Circulation 103:2550–2554

    Article  CAS  PubMed  Google Scholar 

  16. Yip HK, Chen MC, Chang HW et al (2002) Angiographic morphologic features of infarct-related arteries and timely reperfusion in acute myocardial infarction: predictors of slow flow and no-reflow. Chest 122:1322–1332

    Article  PubMed  Google Scholar 

  17. Gibson CM, Cannon CP, Daley WL, Dodge JT Jr, Alexander B Jr, Marble SJ et al (1996) TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation 93:879–888

    Article  CAS  PubMed  Google Scholar 

  18. Syed M, Lesch M (1997) Coronary artery aneurysm: a review. Prog Cardiovasc Dis 40:77–84

    Article  CAS  PubMed  Google Scholar 

  19. Slota PA, Fischman DL, Savage MP, Rake R, Goldberg S (1997) Frequency and outcome of development of coronary artery aneurysm after intracoronary stent placement and angioplasty. STRESS Trial Investigators. Am J Cardiol 79:1104–1106

    Article  CAS  PubMed  Google Scholar 

  20. Levisay JP, Roth RM, Schatz RA (2008) Coronary artery aneurysm formation after drug-eluting stent implantation. Cardiovasc Revasc Med 9:284–287

    Article  PubMed  Google Scholar 

  21. Akin I, Kische S, Rehders TC, Schneider H, Turan GR, Kleinfeldt T et al (2011) Very late coronary aneurysm formation with subsequent stent thrombosis secondary to drug-eluting stent. Chin Med J (Engl) 124:3427–3429

    Google Scholar 

  22. Rab ST, King SB 3rd, Roubin GS, Carlin S, Hearn JA, Douglas JS Jr (1991) Coronary aneurysms after stent placement: a suggestion of altered vessel wall healing in the presence of anti-inflammatory agents. J Am Coll Cardiol 18:1524–1528

    Article  CAS  PubMed  Google Scholar 

  23. Bavry AA, Chiu JH, Jefferson BK, Karha J, Bhatt DL, Ellis SG et al (2007) Development of coronary aneurysm after drug-eluting stent implantation. Ann Intern Med 146:230–232

    Article  PubMed  Google Scholar 

  24. Virmani R, Kolodgie FD, Farb A (2004) Drug-eluting stents: are they really safe? Am Heart Hosp J 2:85–88

    Article  PubMed  Google Scholar 

  25. Stone GW, Ellis SG, Cannon L, Mann JT, Greenberg JD, Spriggs D et al (2005) Comparison of a polymer-based paclitaxel-eluting stent with a bare metal stent in patients with complex coronary artery disease: a randomized controlled trial. JAMA 294:1215–1223

    Article  CAS  PubMed  Google Scholar 

  26. Vassilev D, Hazan M, Dean L (2012) Aneurysm formation after drug-eluting balloon treatment of drug-eluting in-stent restenosis: first case report. Catheter Cardiovasc Interv 80:1223–1226

    Article  PubMed  Google Scholar 

  27. Joner M, Finn AV, Farb A, Mont EK, Kolodgie FD, Ladich E et al (2006) Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol 48:193–202

    Article  PubMed  Google Scholar 

  28. Ako J, Morino Y, Honda Y, Hassan A, Sonoda S, Yock PG et al (2005) Late incomplete stent apposition after sirolimus-eluting stent implantation: a serial intravascular ultrasound analysis. J Am Coll Cardiol 46:1002–1005

    Article  CAS  PubMed  Google Scholar 

  29. Lee YS, Kim KS, Chang SG (2009) Three aneurysms developed in three different drug-eluting stents. Eur Heart J 30:1309

    Article  PubMed Central  PubMed  Google Scholar 

  30. Ozden K, Sengül C, Fotbolcu H, Dindar I (2012) A late coronary aneurysm after sirolimus stent implantation which was treated with coronary graft stent]. Turk Kardiyol Dern Ars 40:440–443

    Article  PubMed  Google Scholar 

  31. Furman MI, Gore JM, Anderson FA, Budaj A, Goodman SG, Avezum A et al (2004) Elevated leukocyte count and adverse hospital events in patients with acute coronary syndromes: findings from the Global Registry of Acute Coronary Events (GRACE). Am Heart J 147:42–48

    Article  PubMed  Google Scholar 

  32. Drakopoulou M, Toutouzas K, Stefanadi E, Tsiamis E, Tousoulis D, Stefanadis C (2009) Association of inflammatory markers with angiographic severity and extent of coronary artery disease. Atherosclerosis 206:335–339

    Article  CAS  PubMed  Google Scholar 

  33. Duffy BK, Gurm HS, Rajagopal V, Gupta R, Ellis SG, Bhatt DL (2006) Usefulness of an elevated neutrophil -to-lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol 97:993–996

    Article  PubMed  Google Scholar 

  34. Wilson WR, Evans J, Bell PR, Thompson MM (2005) HMG-CoA reductase inhibitors (statins) decrease MMP-3 and MMP-9 concentrations in abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 30:259–262

    Article  CAS  PubMed  Google Scholar 

  35. Sukhija R, Aronow WS, Sandhu R, Kakar P, Babu S (2006) Mortality and size of abdominal aortic aneurysm at long-term follow-up of patients not treated surgically and treated with and without statins. Am J Cardiol 97:279–280

    Article  PubMed  Google Scholar 

  36. Ozbay Y, Akbulut M, Balin M, Kayancicek H, Baydas, Korkmaz H (2007) The level of hs-CRP in coronary artery ectasia and its response to statin and an- giotensin-converting enzyme inhibitor treatment. Med Inflamm 2007:89649

    Article  Google Scholar 

Download references

Conflict of interest

No conflicts to disclosure

Author information

Authors and Affiliations

  1. Cardiology Department, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey

    Can Yucel Karabay, Ahmet Guler, Vecih Oduncu, Taylan Akgun, Arzu Kalayci, Alev Kılıcgedik, Onur Tasar, Sedat Kalkan, Ayhan Erkol, Akin İzgi, Ali Metin Esen & Cevat Kirma

  2. Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy

    Gonenc Kocabay

Authors
  1. Can Yucel Karabay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gonenc Kocabay
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ahmet Guler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Vecih Oduncu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Taylan Akgun
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Arzu Kalayci
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alev Kılıcgedik
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Onur Tasar
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Sedat Kalkan
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ayhan Erkol
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Akin İzgi
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Ali Metin Esen
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Cevat Kirma
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Can Yucel Karabay.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Karabay, C.Y., Kocabay, G., Guler, A. et al. Predictors of coronary artery aneurysm after stent implantation in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. Int J Cardiovasc Imaging 30, 1435–1444 (2014). https://doi.org/10.1007/s10554-014-0503-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-014-0503-z

Keywords

Search

Navigation