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Periprocedural Myocardial Infarction: Review and Classification
Journal article   Open access   Peer reviewed

Periprocedural Myocardial Infarction: Review and Classification

Elias B. Hanna and Thomas A. Hennebry
Clinical cardiology (Mahwah, N.J.), Vol.33(8), pp.476-483
08/01/2010
DOI: 10.1002/clc.20819
PMCID: PMC6653301
PMID: 20734444
url
https://doi.org/10.1002/clc.20819View
Published (Version of record) Open Access

Abstract

Technical and pharmacologic advances have reduced the occurrence of large periprocedural myocardial infarction (PMI) after percutaneous coronary interventions (PCI), but PMI still occurs in 6% to 18% of the cases and is associated with impaired short- and long-term survival. PMI might be due to side branch closure or flow-limiting dissection, but is most often diagnosed after apparently uncomplicated PCI and is due to atheroembolization into the microcirculation. Various definitions of PMI are used in clinical trials, but a rise in creatine kinase-MB greater than 3 to 8 times the upper limit of normal is consistently associated with worse prognosis, particularly as it reflects a more extensive and unstable atherosclerotic burden. On the other hand, data regarding the independent prognostic value of periprocedural troponin increase are conflicting. Some data suggest that PM! has a better prognosis than a spontaneously occurring myocardial infarction, and that its incidence is reduced with aggressive antiplatelet and statin therapy.
Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Life Sciences & Biomedicine Science & Technology

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