Xiaoyu Yang1,2, Hector Tamez1,2, Carol Lai1,2, Kalon Ho1,2, Donald Cutlip1,2. 1. Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. 2. Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Abstract
OBJECTIVES: To assess the incidence of and outcomes related to periprocedural (Type 4a) myocardial infarction (MI) in a cohort of patients undergoing percutaneous coronary intervention (PCI) for stable coronary disease or non ST-elevation acute coronary syndrome with stable or falling cardiac troponin levels. BACKGROUND: The 2012 Third Universal Definition for Type 4a MI has not been prospectively studied in routine clinical practice. METHODS: The study included 516 patients undergoing eligible PCI at a single institution. Data were extracted from the National Cardiovascular Data Registry, review of electronic medical records, and telephone interviews. Clinical outcomes assessed at one year included all-cause mortality, recurrent MI, or any repeat coronary revascularization. RESULTS: Based on the Third Universal Definition of MI, 53 (10.3%) patients met criteria for Type 4a MI and 116 (22.5%) had myocardial injury. The Type 4a MI and myocardial injury groups each had significantly higher numbers of stents, longer stent lengths, and more use of rotational atherectomy than the control group. Type 4a MI was not associated with one-year mortality. The composite endpoint of death or recurrent MI at one year was similar between the Type 4a MI and myocardial injury groups (12 vs. 11%; P > 0.05), which were both higher compared with the control group (3%; P = 0.02, 0.03). CONCLUSIONS: Type 4a MI and myocardial injury were frequent, and were associated with more complicated index PCI and more frequent death or recurrent MI at one year as compared with the control group.
OBJECTIVES: To assess the incidence of and outcomes related to periprocedural (Type 4a) myocardial infarction (MI) in a cohort of patients undergoing percutaneous coronary intervention (PCI) for stable coronary disease or non ST-elevation acute coronary syndrome with stable or falling cardiac troponin levels. BACKGROUND: The 2012 Third Universal Definition for Type 4a MI has not been prospectively studied in routine clinical practice. METHODS: The study included 516 patients undergoing eligible PCI at a single institution. Data were extracted from the National Cardiovascular Data Registry, review of electronic medical records, and telephone interviews. Clinical outcomes assessed at one year included all-cause mortality, recurrent MI, or any repeat coronary revascularization. RESULTS: Based on the Third Universal Definition of MI, 53 (10.3%) patients met criteria for Type 4a MI and 116 (22.5%) had myocardial injury. The Type 4a MI and myocardial injury groups each had significantly higher numbers of stents, longer stent lengths, and more use of rotational atherectomy than the control group. Type 4a MI was not associated with one-year mortality. The composite endpoint of death or recurrent MI at one year was similar between the Type 4a MI and myocardial injury groups (12 vs. 11%; P > 0.05), which were both higher compared with the control group (3%; P = 0.02, 0.03). CONCLUSIONS: Type 4a MI and myocardial injury were frequent, and were associated with more complicated index PCI and more frequent death or recurrent MI at one year as compared with the control group.
Authors: Johanne Silvain; Michel Zeitouni; Valeria Paradies; Huili L Zheng; Gjin Ndrepepa; Claudio Cavallini; Dimitri N Feldman; Samin K Sharma; Julinda Mehilli; Sebastiano Gili; Emanuele Barbato; Giuseppe Tarantini; Sze Y Ooi; Clemens von Birgelen; Allan S Jaffe; Kristian Thygesen; Gilles Montalescot; Heerajnarain Bulluck; Derek J Hausenloy Journal: Eur Heart J Date: 2021-01-21 Impact factor: 29.983
Authors: Heerajnarain Bulluck; Valeria Paradies; Emanuele Barbato; Andreas Baumbach; Hans Erik Bøtker; Davide Capodanno; Raffaele De Caterina; Claudio Cavallini; Sean M Davidson; Dmitriy N Feldman; Péter Ferdinandy; Sebastiano Gili; Mariann Gyöngyösi; Vijay Kunadian; Sze-Yuan Ooi; Rosalinda Madonna; Michael Marber; Roxana Mehran; Gjin Ndrepepa; Cinzia Perrino; Stefanie Schüpke; Johanne Silvain; Joost P G Sluijter; Giuseppe Tarantini; Gabor G Toth; Linda W Van Laake; Clemens von Birgelen; Michel Zeitouni; Allan S Jaffe; Kristian Thygesen; Derek J Hausenloy Journal: Eur Heart J Date: 2021-07-15 Impact factor: 29.983