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The clinical approa...
The clinical approach to diagnosing peri-procedural myocardial infarction after percutaneous coronary interventions according to the fourth universal definition of myocardial infarction - from the study group on biomarkers of the European Society of Cardiology (ESC) Association for Acute CardioVascular Care (ACVC)
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Mair, J. (author)
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Jaffe, A. (author)
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Lindahl, B. (author)
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Mills, N. (author)
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Mockel, M. (author)
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Cullen, L. (author)
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Giannitsis, E. (author)
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- Hammarsten, Ola (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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Huber, K. (author)
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Krychtiuk, K. (author)
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Mueller, C. (author)
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Thygesen, K. (author)
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(creator_code:org_t)
- 2022-05-26
- 2022
- English.
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In: Biomarkers. - : Informa UK Limited. - 1354-750X .- 1366-5804. ; 27:5, s. 407-417
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https://doi.org/10.1...
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Abstract
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- Purpose This review intends to illustrate basic principles on how to apply the Fourth Universal Definition of Myocardial Infarction (UDMI) for the diagnosis of peri-procedural myocardial infarction (MI) after percutaneous coronary interventions (PCI) in clinical practice. Methods and Results Review of routine case-based events. Increases in cardiac troponin (cTn) concentrations are common after elective PCI in patients with chronic coronary syndrome (CCS). Peri-procedural PCI-related MI (type 4a MI) in CCS patients should be diagnosed in cases of major peri-procedural acute myocardial injury indicated by an increase in cTn concentrations of >5-times the 99th percentile upper reference limit (URL) together with evidence of new peri-procedural myocardial ischaemia as demonstrated by electrocardiography (ECG), imaging, or flow-limiting peri-procedural complications in coronary angiography. Measurement of cTn baseline concentrations before elective PCI is useful. In patients presenting with acute MI undergoing PCI, peri-procedural increases in cTn concentrations are usually due to their index presentation and not PCI-related, apart from obvious major peri-procedural complications, such as persistent occlusion of a large side branch or no-reflow after stent implantation. Conclusion The distinction between type 4a MI, PCI-related acute myocardial injury, and chronic myocardial injury can be challenging in individuals undergoing PCI. Careful integration of all available clinical data is essential for correct classification.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Percutaneous coronary intervention
- myocardial infarction
- universal
- definition of myocardial infarction
- myocardial injury
- cardiac troponin
- high-sensitivity troponin
- i elevation
- consensus document
- injury
- angioplasty
- angiography
- mortality
- occlusion
- impact
- Biotechnology & Applied Microbiology
- Toxicology
Publication and Content Type
- ref (subject category)
- art (subject category)
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Biomarkers
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- By the author/editor
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Mair, J.
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Jaffe, A.
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Lindahl, B.
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Mills, N.
-
Mockel, M.
-
Cullen, L.
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show more...
-
Giannitsis, E.
-
Hammarsten, Ola
-
Huber, K.
-
Krychtiuk, K.
-
Mueller, C.
-
Thygesen, K.
-
show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Biomarkers
- By the university
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University of Gothenburg