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Review
. 2022 Sep 13;23(9):309.
doi: 10.31083/j.rcm2309309. eCollection 2022 Sep.

Periprocedural Myocardial Infarction following Elective Percutaneous Coronary Interventions

Antonio Landi  1 , Claudio Montalto  2 , Gabriele Crimi  3 , Stefano De Servi  4
Affiliations
Review

Periprocedural Myocardial Infarction following Elective Percutaneous Coronary Interventions

Antonio Landi et al. Rev Cardiovasc Med. .

Abstract

The prognostic relevance of periprocedural myocardial infarction (PMI) in patients with chronic coronary syndrome undergoing percutaneous coronary intervention (PCI) is still matter of debate, particularly regarding the type (cardiac troponin or creatin kinase-MB) and different thresholds of biomarkers elevation, as the importance of associated ancillary criteria of ischemia or concomitant angiographic complications. There are still uncertainties regarding the value of PMI as event which is prognostically equivalent to spontaneous myocardial infarction or if it simply represents a marker of baseline risk, atherosclerotic burden and procedural complexity. In the present review, we will present the mechanisms and predictors of PMI occurring during PCI and potential treatment strategies to reduce its occurrence. We will also overview all commonly adopted definitions of PMI, which carry different prevalence and prognostic implications in daily practice and clinical trials. Finally, we will discuss the impact of different PMI definitions on the interpretation of trials results, emphasizing the importance of adequate endpoints selection in the planning and interpretation of clinical trials.

Keywords: chronic coronary syndrome; percutaneous coronary intervention; periprocedural myocardial infarction.

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Conflict of interest statement

The authors declare no conflict of interest. Stefano De Servi is serving as one of the Editorial Board members of this journal. We declare that Stefano De Servi had no involvement in the peer review of this article and has no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to Federico Ronco.

Figures

Fig. 1.
Fig. 1.
Main causes of periprocedural myocardial infarction.
Fig. 2.
Fig. 2.
Different rates of periprocedural myocardial infarction in chronic coronary syndromes patients undergoing PCI according to the various definitions used. Abbreviations: UDMI, universal definition of myocardial infarction; ARC-2, Academic Research Consortium-2; SCAI, Society for Cardiac Angiography and Interventions.
See this image and copyright information in PMC

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