Incidence and impact on prognosis of peri-procedural myocardial infarction in 2760 elective patients with stable angina pectoris in a historical prospective follow-up studyReport as inadecuate




Incidence and impact on prognosis of peri-procedural myocardial infarction in 2760 elective patients with stable angina pectoris in a historical prospective follow-up study - Download this document for free, or read online. Document in PDF available to download.

BMC Cardiovascular Disorders

, 16:140

Coronary artery disease

Abstract

BackgroundThe clinical significance of myocardial infarction related to treatment with percutaneous coronary intervention PCI has been subject of great discussion. This subject has been studied for many years using different definitions of peri-procedural myocardial infarction and different biomarkers, the results have varied greatly depending on methods and time of the study. This study was to determine the incidence and prognostic significance of elevated cardiac biomarkers after elective PCI in patients with stable angina pectoris using the current cut-off set by the Third Universal Definition of Myocardial Infarction and current biomarkers.

MethodsWe performed a historical prospective follow-up study of all patients with stable angina pectoris who underwent elective PCI at Aalborg University Hospital, Denmark from January 1 2000 to December 31 2012. We stratified patients according to peak post-PCI troponin T cTnT and Creatine Kinase MB mass CK-MBmass.

ResultsFollow-up for time to all-cause mortality was mean 5.8 years and total 15,891 years and mean 3.7 years and total 10,160 years for the combined endpoint of all-cause mortality and new onset heart failure. During the follow up period 399 of 2760 patients died 14.5 % and 1095 39.7 % suffered the combined endpoint. Post-PCI concentration of cTnT and CK-MBmass was elevated above the defined cut-off in 419 patients 15.2 % and 113 patients 4.1 % respectively. There was no statistically significant difference between the groups in stratified analysis of the hazard rates by time regarding all-cause mortality for cTnT nor CK-MBmass. Regarding the combined endpoint the results were ambiguous. The results were unchanged in multivariable analyses that included age and gender.

ConclusionThe incidence of elevated biomarkers after elective PCI in patients with stable angina pectoris using the defined cut-off >5 x URL was 15.2 % using cTnT and 4.1 % using CK-MBmass. The independent prognostic value for both cardiac biomarkers of any cut-off showed no statistical significance for all-cause mortality, whereas the combined endpoint all-cause mortality or new-onset heart failure were ambiguous in both short- and long-term follow-up.

KeywordsTroponin Elective Prognosis Myocardial infarction Peri-procedural Percutaneous coronary intervention  Download fulltext PDF



Author: Martin Kirk Christensen - Hui Huang - Christian Torp-Pedersen - Torleif Trydal - Jan Ravkilde

Source: https://link.springer.com/







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