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Frequency, causes, predictors, and clinical significance of peri-procedural myocardial infarction following percutaneous coronary intervention.
MedLine Citation:
PMID:  23404537     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AimsPeri-procedural myocardial infarction (MI) is a not infrequent complication of percutaneous coronary intervention (PCI), but conflicting information exists regarding incidence and prognostic impact of this event. We investigated frequency, causes, predictors, and clinical relevance of peri-procedural MI, using a large database.Methods and resultsWe pooled individual patient-level data from 11 PCI studies in which peri-procedural creatine kinase-MB mass was routinely measured and mortality data were prospectively collected. Among 23 604 patients from 11 studies, 1677 {7.1% [95% confidence interval (CI) 6.8-7.5%]} had peri-procedural MI. The most common mechanism of peri-procedural MI was side-branch occlusion. Independent predictors of peri-procedural MI were older age, female gender, diabetes, hypertension, renal dysfunction, multivessel disease, left anterior descending artery disease, left main disease, bifurcation lesion, long lesion, drug-eluting stents, and number of stents. Follow-up varied from 1 year to 5 years. In a crude analysis, patients with peri-procedural MI had significantly a higher risk of mortality than those without peri-procedural MI [hazard ratio (HR) 1.47; 95% CI 1.24-1.74]. After adjustment for baseline covariates, peri-procedural MI was associated with an increased risk of mortality (HR 1.20; 95% CI 1.04-1.39).ConclusionAmong patients undergoing PCI, the occurrence of peri-procedural MI measured by CK-MB mass assay was ∼7%, and more than half of cases were associated with side-branch occlusion. Several higher risk patients, lesions, and procedural characteristics were independent predictors of peri-procedural MI. Peri-procedural MI was associated with an increase in mortality.
Authors:
Duk-Woo Park; Young-Hak Kim; Sung-Cheol Yun; Jung-Min Ahn; Jong-Young Lee; Won-Jang Kim; Soo-Jin Kang; Seung-Whan Lee; Cheol Whan Lee; Seong-Wook Park; Seung-Jung Park
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-12
Journal Detail:
Title:  European heart journal     Volume:  -     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, Korea.
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