Periprocedural myocardial infarction in patients undergoing complex versus noncomplex percutaneous coronary intervention.

Autor: Piccolo R; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy., Leone A; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy., Simonetti F; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy., Avvedimento M; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy., Angellotti D; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy., Manzi L; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy., Verde N; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy., Spaccarotella CAM; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy., Di Serafino L; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy., Cirillo P; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy., Gargiulo G; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy., Fortunato G; Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II and CEINGE S.C.a r.l. Advanced Biotechnology, Naples, Italy., Franzone A; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy., Esposito G; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
Jazyk: angličtina
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2023 Aug; Vol. 102 (2), pp. 212-220. Date of Electronic Publication: 2023 Jun 19.
DOI: 10.1002/ccd.30749
Abstrakt: Background: Limited data are available on the risk of periprocedural myocardial infarction (MI) in patients undergoing complex versus noncomplex percutaneous coronary intervention (PCI).
Methods: We assessed the risk of periprocedural MI according to the fourth Universal definition of myocardial infarction (UDMI) and several other criteria among patients undergoing elective PCI in a prospective, single-center registry. Complex PCI included at least one of the following: 3 coronary vessels treated, ≥3 stents implanted, ≥3 lesions treated, bifurcation with 2 stents implanted, total stent length >60 mm, treatment of chronic total occlusion, and use of rotational atherectomy.
Results: Between 2017 and 2021, we included 1010 patients with chronic coronary syndrome, of whom 226 underwent complex PCI (22.4%). The rate of periprocedural MI according to the fourth UDMI was significantly higher in complex compared to noncomplex PCI patients (26.5% vs. 14.5%, p < 0.001). Additionally, periprocedural MI was higher in the complex PCI group using SCAI (4% vs. 1.1%, p = 0.009), ARC-2 (13.7% vs. 8.0%, p = 0.013), ISCHEMIA (5.8% vs. 1.7%, p = 0.002), and EXCEL criteria (4.9% vs. 2.0%, p = 0.032). SYNTAX periprocedural MI occurred at low rates in both groups (0.9% vs. 0.6%, p = 0.657). Complex PCI was an independent predictor of the fourth UDMI periprocedural MI (odds ratio [OR] 1.54, 95% confidence interval [CI]: 1.04-2.27, p = 0.031).
Conclusions: In patients with chronic coronary syndrome undergoing elective PCI, complex PCI is associated with a significantly higher risk of periprocedural MI using multiple definitions. These findings highlight the importance of considering upfront this risk in the planning of complex PCI procedures.
(© 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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