BACKGROUND: Peri-procedural myocardial injury (PPI) during percutaneous coronary intervention (PCI) is common and associated with a poor outcome. No reliable angiographic or clinical predictors of PPI exist. We evaluated the ability of the SYNTAX score (SXscore), Gensini score, American Heart Association/American College of Cardiology (AHA/ACC) and Society for Cardiovascular Angiography and Intervention (SCAI) classifications to predict PPI. METHODS: Consecutive patients were included from two existing databases of PCI. Patients with coronary bypass grafts or instent restenosis were excluded. PPI was defined as troponin I elevation (>1.0 microg/L) at 6-24 h post-PCI. Delayed enhancement magnetic resonance imaging distinguished PPI territory in patients undergoing multi-vessel PCI. Quantitative coronary angiography was performed blinded to PPI. In total, 100 patients underwent PCI to 122 vessels. PPI occurred in 20/100 (20.0%) patients. RESULTS: Mean patient SXscore was higher in patients with PPI (20.6 vs. 12.4, p = 0.0001), however Gensini score was not significantly different (34.2 vs. 27.3, p = 0.15). Mean vessel SXscore was higher in vessels associated with PPI (12.1 vs. 7.6, p = 0.002), but not different for vessel Gensini score (16.2 vs. 13.6, p = 0.42). No vessels with AHA type A or B1 lesions were associated with PPI. Higher AHA scores (B2 and C) were associated with PPI (chi2 for trend 11.6, p = 0.0007). SCAI scores were not predictive of PPI (chi2 for trend 3.6, p = 0.06). By ROC analysis, a patient SXscore of > or = 17 predicted PPI with a sensitivity of 75.0% and specificity of 70.0%. CONCLUSION: Higher SXscores are predictive of myocardial injury, whilst AHA type A and B1 lesions have a high negative predictive value for PPI.
BACKGROUND: Peri-procedural myocardial injury (PPI) during percutaneous coronary intervention (PCI) is common and associated with a poor outcome. No reliable angiographic or clinical predictors of PPI exist. We evaluated the ability of the SYNTAX score (SXscore), Gensini score, American Heart Association/American College of Cardiology (AHA/ACC) and Society for Cardiovascular Angiography and Intervention (SCAI) classifications to predict PPI. METHODS: Consecutive patients were included from two existing databases of PCI. Patients with coronary bypass grafts or instent restenosis were excluded. PPI was defined as troponin I elevation (>1.0 microg/L) at 6-24 h post-PCI. Delayed enhancement magnetic resonance imaging distinguished PPI territory in patients undergoing multi-vessel PCI. Quantitative coronary angiography was performed blinded to PPI. In total, 100 patients underwent PCI to 122 vessels. PPI occurred in 20/100 (20.0%) patients. RESULTS: Mean patient SXscore was higher in patients with PPI (20.6 vs. 12.4, p = 0.0001), however Gensini score was not significantly different (34.2 vs. 27.3, p = 0.15). Mean vessel SXscore was higher in vessels associated with PPI (12.1 vs. 7.6, p = 0.002), but not different for vessel Gensini score (16.2 vs. 13.6, p = 0.42). No vessels with AHA type A or B1 lesions were associated with PPI. Higher AHA scores (B2 and C) were associated with PPI (chi2 for trend 11.6, p = 0.0007). SCAI scores were not predictive of PPI (chi2 for trend 3.6, p = 0.06). By ROC analysis, a patient SXscore of > or = 17 predicted PPI with a sensitivity of 75.0% and specificity of 70.0%. CONCLUSION: Higher SXscores are predictive of myocardial injury, whilst AHA type A and B1 lesions have a high negative predictive value for PPI.
Authors: E M Bakirci; K Kalkan; H Hamur; M Buyuklu; M Cetin; H Degirmenci; H Duman; Z Kucuksu; I H Tanboga; E Topal Journal: Herz Date: 2014-01-19 Impact factor: 1.443
Authors: Yavuz Karabağ; Metin Çağdaş; Ibrahim Rencuzogullari; Süleyman Karakoyun; İnanç Artaç; Doğan İliş; Eray Atalay; Mahmut Yesin; Mustafa Ozan Gürsoy; Ibrahim Halil Tanboğa Journal: J Clin Lab Anal Date: 2018-04-18 Impact factor: 2.352
Authors: Issam D Moussa; Lloyd W Klein; Binita Shah; Roxana Mehran; Michael J Mack; Emmanouil S Brilakis; John P Reilly; Gilbert Zoghbi; Elizabeth Holper; Gregg W Stone Journal: J Am Coll Cardiol Date: 2013-10-22 Impact factor: 24.094