Incidence, predictors and clinical significance of periprocedural myocardial injury in patients undergoing elective percutaneous coronary intervention

被引:19
作者
Zhou, You [1 ]
Chen, Zhangwei [1 ]
Ma, Jiaqi [1 ]
Chen, Ao [1 ]
Lu, Danbo [1 ]
Wu, Yuan [1 ]
Ren, Daoyuan [1 ]
Zhang, Chi [1 ]
Dai, Chunfeng [1 ]
Zhang, Yaqi [1 ]
Qian, Juying [1 ]
Ge, Junbo [1 ]
机构
[1] Fudan Univ, Shanghai Inst Cardiovasc Dis, Zhongshan Hosp, Dept Cardiol, 180 Fenglin Rd, Shanghai 200032, Peoples R China
基金
中国国家自然科学基金;
关键词
Periprocedural myocardial injury; Percutaneous coronary intervention; Cardiac troponin T; CREATINE KINASE-MB; CARDIAC TROPONIN-T; PROGNOSTIC VALUE; MICROEMBOLIZATION; INFARCTION; MYONECROSIS; ELEVATION; DIAGNOSIS; IMPACT; DAMAGE;
D O I
10.1016/j.jjcc.2020.03.008
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Although technological and equipment innovations have given rise to delicate and safe coronary intervention procedures, periprocedural myocardial injury (PMI) is still one of the common complications. The relationship between PMI, defined by various biomarker thresholds, and clinical prognosis remains controversial. We sought to assess the determinants and prognosis of PMI in patients with stable coronary artery disease (CAD) undergoing elective percutaneous coronary intervention (PCI). Methods: Consecutive stable CAD patients with negative preoperative troponin T levels undergoing elective PCI in our hospital were enrolled from July 2017 to December 2017. PMI was defined as troponin T values >99th percentile upper reference limit (URL) within 16-24 h post-PCI. The correlation of cardiovascular events and PMI was assessed after a median follow-up of 18 months. Results: PMI occurred in 45.3% of the 1572 patients included, with 11.2% having troponin T levels elevated more than 5 times the URL after PCI. Independent risk factors for PMI were age >= 65 years, prior PCI, bifurcation lesion, stent number, and multivessel disease. During the follow-up period, patients with PMI had a higher incidence of unplanned revascularization [10.8% vs. 7.2%, adjusted hazard ratio (adHR) 1.40, 95% confidence interval (CI) 1.04-2.06; p = 0.045] and target vessel revascularization (5.8% vs. 2.7%, adHR 1.90, 95% CI 1.06-3.38; p = 0.030) than those without PMI. However, no significant impact of PMI on the risk of death and myocardial infarction was found. Conclusions: PMI defined by troponin T levels >99th percentile URL correlated with an increased risk of cardiovascular events in stable CAD patients undergoing elective PCI. (C) 2020 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:309 / 316
页数:8
相关论文
共 50 条
[41]   Prognostic Impact of Periprocedural Myocardial Infarction in Patients Undergoing Elective Percutaneous Coronary Interventions [J].
Koskinas, Konstantinos C. ;
Ndrepepa, Gjin ;
Raeber, Lorenz ;
Karagiannis, Alexios ;
Kufner, Sebastian ;
Zanchin, Thomas ;
Hieber, Julia ;
Hunziker, Lukas ;
Mayer, Katharina ;
Byrne, Robert A. ;
Heg, Dik ;
Windecker, Stephan ;
Kastrati, Adnan .
CIRCULATION-CARDIOVASCULAR INTERVENTIONS, 2018, 11 (12)
[42]   Frequency and outcomes of periprocedural myocardial infarction in patients with chronic coronary syndromes undergoing percutaneous coronary intervention [J].
Ueki, Yasushi ;
Raber, Lorenz .
CURRENT OPINION IN CARDIOLOGY, 2022, 37 (06) :488-494
[43]   Periprocedural myocardial injury during elective percutaneous coronary intervention: is it important and how can it be prevented? [J].
Cuculi, F. ;
Lim, C. C. S. ;
Banning, A. P. .
HEART, 2010, 96 (10) :736-740
[44]   Perioperative Myocardial Injury/Infarction in Patients with Stable or Unstable Angina Pectoris Undergoing Elective Percutaneous Coronary Intervention: The Effects of Preoperative Lipid Management [J].
Chen, Xuefeng ;
Bai, Wenlou ;
Qi, Peng ;
Zhang, Yantao ;
Yao, Wenjing ;
Dang, Yi .
INTERNATIONAL JOURNAL OF GENERAL MEDICINE, 2025, 18 :939-945
[45]   Multimodality coronary imaging to predict periprocedural myocardial necrosis after an elective percutaneous coronary intervention [J].
Hoshino, Masahiro ;
Yonetsu, Taishi ;
Murai, Tadashi ;
Kanaji, Yoshihisa ;
Usui, Eisuke ;
Yamaguchi, Masao ;
Hada, Masahiro ;
Hamaya, Rikuta ;
Kanno, Yoshinori ;
Lee, Tetsumin ;
Kakuta, Tsunekazu .
CORONARY ARTERY DISEASE, 2018, 29 (03) :237-245
[46]   Association of Pre-procedural Nutritional Indicators with Periprocedural Myocardial Infarction in Patients Undergoing Elective Percutaneous Coronary Intervention [J].
Liu, Lu ;
Jin, Jinhua ;
Wang, Manjun ;
Xu, Xiaoyun ;
Jiang, Hangpan ;
Chen, Zhezhe ;
Li, Ya ;
Gao, Jing ;
Zhang, Wenbin .
INTERNATIONAL HEART JOURNAL, 2023, 64 (03) :417-426
[47]   Prevention of Periprocedural Myocardial Injury During Percutaneous Coronary Intervention in Patients With Stable Coronary Artery Disease [J].
Ito, Shin ;
Kitakaze, Masafumi .
CIRCULATION JOURNAL, 2018, 82 (07) :1746-1748
[48]   The influence of aortic valve calcification on the risk of periprocedural myocardial injury after elective coronary intervention [J].
Chen, Zhang-Wei ;
Yang, Hong-Bo ;
Chen, Ying-Hua ;
Qian, Ju-Ying ;
Shu, Xian-Hong ;
Ge, Jun-Bo .
AGING CLINICAL AND EXPERIMENTAL RESEARCH, 2015, 27 (05) :631-636
[49]   Relationship Between Preoperative Low-Density Lipoprotein Cholesterol and Periprocedural Myocardial Injury in Patients Following Elective Percutaneous Coronary Intervention in Southern China [J].
Zhong, Zhixiong ;
Liu, Jing ;
Zhang, Qifeng ;
Zhong, Wei ;
Li, Bin ;
Li, Cunren ;
Liu, Zhidong ;
Yang, Min ;
Zhao, Pingsen .
MEDICAL SCIENCE MONITOR, 2018, 24 :4154-4161
[50]   Impact of Periprocedural Myocardial Biomarker Elevation on Mortality Following Elective Percutaneous Coronary Intervention [J].
Garcia-Garcia, Hector M. ;
McFadden, Eugene P. ;
von Birgelen, Clemens ;
Rademaker-Havinga, Tessa ;
Spitzer, Ernest ;
Kleiman, Neal S. ;
Cohen, David J. ;
Kennedy, Kevin F. ;
Camenzind, Edoardo ;
Mauri, Laura ;
Steg, Philippe Gabriel ;
Wijns, William ;
Silber, Sigmund ;
van Es, Gerrit-Anne ;
Serruys, Patrick W. ;
Windecker, Stephan ;
Cutlip, Donald ;
Vranckx, Pascal .
JACC-CARDIOVASCULAR INTERVENTIONS, 2019, 12 (19) :1954-1962