eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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2/2020
vol. 16
 
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abstract:
Original paper

Insulin-like growth factor-1 levels predict myocardial injury and infarction after elective percutaneous coronary intervention: an optical coherence tomography study

Onur Tasar
1
,
Gonenc Kocabay
2
,
Yavuz Karabag
3
,
Arzu Kalayci Karabay
2
,
Can Yucel Karabay
4
,
Sedat Kalkan
2
,
Cevat Kirma
2

  1. Department of Cardiology, Elazig Research and Training Hospital, Elazig, Turkey
  2. Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey
  3. Department of Cardiology, Kars Kafkas University Medicine, Faculty Hospital, Kars, Turkey
  4. Department of Cardiology, Siyami Ersek Heart Center, Istanbul, Turkey
Adv Interv Cardiol 2020; 16, 2 (60): 162–169
DOI: https://doi.org/10.5114/aic.2020.96059
Online publish date: 2020/06/23
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Introduction
Periprocedural myocardial necrosis, which can range from a low level elevation of cardiac biomarkers to a large myocardial infarction (MI), is a common complication after percutaneous coronary intervention (PCI).

Aim
We hypothesized that insulin-like growth factor-1 (IGF-1) levels may play a protective role in myocardial injury after coronary stent placement and aimed to investigate the relationship between IGF-1 levels and plaque characteristics assessed by optical coherence tomography (OCT).

Material and methods
Between May 2015 and December 2015 we prospectively enrolled 74 patients with stable angina pectoris in whom single de novo coronary artery stenosis was present. PCI was performed according to standard methods. OCT was applied to all patients. TnT was analyzed at admission, before PCI and at 6, 12, 24 and 48 h after PCI. Serum IGF-1 was measured prior to PCI.

Results
A total of 25 (33.7%) patients had periprocedural myocardial injury or type 4a myocardial infarction, and 49 (66.2%) patients had no events. IGF-1 level and reference intimal thickness, medial thickness, and plaque fibrous cap thickness in OCT had strong correlations (r = 0.88, 0.80 and 0.88 respectively, p < 0.001). IGF-1 was an independent predictor of periprocedural myocardial injury or type 4a MI in univariate (OR = 0.929, 95% CI: 0.895–0.964, p < 0.001) and multivariate regression analysis (OR = 0.757, 95% CI: 0.575–0.998, p = 0.04). Based on ROC analysis, the best cut-off value of IGF-1 for predicting periprocedural myocardial injury or type 4a myocardial infarction was 144.5 ng/ml, with a maximum sensitivity of 88% and specificity of 77.6% (AUC = 0.80, 95% CI: 0.69–0.88, p < 0.0001).

Conclusions
The results from this study indicate that low IGF-1 levels are associated with plaque instability assessed by OCT. Low IGF-1 levels may identify patients who are at increased risk for periprocedural myocardial injury/infarction.

keywords:

insulin-like growth factor-1 levels, myocardial injury, percutaneous coronary intervention
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