Assessment of Silent Neuronal Injury Following Coronary Angiography and Intervention in Patients With Acute Coronary Syndrome

• Published in: Clinical and applied thrombosis/hemostasis Vol. 22; no. 1; pp. 52 - 59
• Main Authors: Aykan, Ahmet Çağrı, Gökdeniz, Tayyar, Bektaş, Hüseyin, Boyacı, Faruk, Gül, İlker, Hatem, Engin, Kalaycıoğlu, Ezgi, Turan, Turhan, Çevirme, Deniz, Çelik, Şükrü
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.01.2016; SAGE PUBLICATIONS, INC
• Subjects: Acute Coronary Syndrome - blood; Acute Coronary Syndrome - diagnostic imaging; Acute Coronary Syndrome - physiopathology; Acute Coronary Syndrome - surgery; Acute coronary syndromes; Aged; Angioplasty; Cerebrovascular Disorders - blood; Cerebrovascular Disorders - diagnostic imaging; Cerebrovascular Disorders - etiology; Cerebrovascular Disorders - physiopathology; Coronary Angiography - adverse effects; Female; Humans; Male; Medical imaging; Middle Aged; Neurons; Percutaneous Coronary Intervention - adverse effects; Phosphopyruvate Hydratase - blood; Postoperative Complications - blood; Postoperative Complications - diagnostic imaging; Postoperative Complications - physiopathology; Prospective Studies; Risk Factors; Ventricular Function, Left; neuron-specific enolase; Syntax score; infarct; myocardial infarction; cerebral
• ISSN: 1076-0296; 1938-2723
• DOI: 10.1177/1076029614532007

The aim of this study is to evaluate the incidence and predictors of silent neuronal injury (SNI) after coronary angiography (CAG) and intervention by serial measurement of serum neuron-specific enolase (NSE) in patients presented with acute coronary syndrome (ACS). Ninety-eight consecutive patients presented with ACS and underwent CAG and intervention were included in the study. The NSE levels significantly increased after CAG and intervention compared to baseline levels (22.03 ± 27.70 and 10.08 ± 3.15 consecutively). Left ventricular ejection fraction in the SNI+ group was significantly lower than that in the SNI− group (43.71% ± 12.51%, 50.84% ± 9.34%, P = .002). Maximal creatinine kinase myocardial band, troponin I, and SYNTAX score of the SNI+ group were significantly higher than those of the SNI− group (103.83 ± 99.22, 51.92 ± 78.33, P = .006; 50.04 ± 66.18, 19.18 ± 30.50, P = .002; 103.83 ± 99.22, 51.92 ± 78.33, P = .006; and 50.04 ± 66.18, 19.18 ± 30.50, P = .002 successively). SYNTAX score and performing percutaneous coronary intervention were the independent predictors of SNI (P = .009, odds ratio [OR] = 1.06, 95% confidence interval [CI] = 1.014-1.107, P = .036, OR = 4.262, 95% CI = 1.097-16.56). Percutaneous coronary intervention and coronary artery lesion complexity may increase the risk of SNI in patients with ACS.