Principal component analysis of categorized parameters in periprocedural myocardial injury following percutaneous coronary intervention

ABSTRACT

Objective: The elevation of troponin-T (Trop-T) or creatinine kinase myocardial isoform (CKMB) is very common during the percutaneous coronary intervention (PCI). A study was attempted to determine the correlation between elevated Trop-T or CKMB and the parameters of PCI by using multivariate analysis, especially principal component analysis (PCA). Materials and Methods: A prospective observational study was carried out among 100 patients who underwent PCI for stable coronary artery disease in which 31 and 37 patients were found to have elevated Trop-T and CKMB (>3 times) following PCI. The correlation was studied between Trop-T or CKMB (dependent variable) and different parameters, viz., total stent length (mm), fluoroscopy time (min), lesion strength, left ventricular (LV) function, procedural complications, type of lesions, vessels treated with drug eluting stent (DES), and major adverse cardiac events (MACE) as independent variables. Results: For Trop-T, the principal component (PC)-1 and PC-2 obtained 63.49% and 30.88% of the original variation. For PC-1 and PC-2, maximum positive loading was recorded for stent length followed by fluoroscopy time and for LV but negative loading for the type of lesion and type of stent (DES vs bare metal stent [BMS]). For CKMB, the PC-1 and PC-2 obtained 61.22% and 32.08% of the original variation. For PC-1 and PC-2, maximum positive loading was recorded for stent length and fluoroscopy time followed by vessel treated but negative loading for the type of stent and MACE, and maximum positive loading recorded for LV function but negative loading for the type of lesion. Conclusion: This study indicates which factors are most important in preventing periprocedural myocardial injury during PCI and may be a suitable tool to prevent myocardial injury and for subsequent less MACE and better patient outcomes.