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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, Johannes (author)
- Med Univ Innsbruck, Heart Ctr, Dept Internal Med Cardiol & Angiol 3, Innsbruck, Austria
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- Jaffe, Allan (author)
- Mayo Clin & Mayo Grad Sch Med, Rochester, MN USA
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- Lindahl, Bertil, 1957- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Institutionen för medicinska vetenskaper
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- Mills, Nicholas (author)
- Univ Edinburgh, Univ BHF Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland.;Univ Edinburgh, Usher Inst, Edinburgh, Midlothian, Scotland
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- Moeckel, Martin (author)
- Charite Univ Med Berlin, Div Emergency Med, Berlin, Germany.;Charite Univ Med Berlin, Dept Cardiol, Berlin, Germany
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- Cullen, Louise (author)
- Univ Queensland, Royal Brisbane & Womens Hosp, Emergency & Trauma Ctr, Brisbane, Qld, Australia
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- Giannitsis, Evangelos (author)
- Heidelberg Univ, Dept Cardiol, Med Klin 3, Heidelberg, Germany
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- Hammarsten, Ola (author)
- Univ Gothenburg, Dept Clin Chem & Transfus Med, Gothenburg, Sweden
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- Huber, Kurt (author)
- Wilhelminen Hosp, Dept Med Cardiol & Intens Care Med 3, Vienna, Austria.;Sigmund Freud Univ Med Sch, Vienna, Austria
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- Krychtiuk, Konstantin (author)
- Med Univ Vienna, Dept Internal Med 2, Vienna, Austria
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- Mueller, Christian (author)
- Univ Basel, Univ Hosp Basel, Dept Cardiol & Cardiovasc Res, Inst Basel, Basel, Switzerland
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- Thygesen, Kristian (author)
- Aarhus Univ Hosp, Dept Cardiol, Aarhus, Denmark
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(creator_code:org_t)
- Taylor & Francis, 2022
- 2022
- English.
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In: Biomarkers. - : Taylor & Francis. - 1354-750X .- 1366-5804. ; 27:5, s. 407-417
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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
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Biomarkers
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Mair, Johannes
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Jaffe, Allan
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Lindahl, Bertil, ...
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Mills, Nicholas
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Moeckel, Martin
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Cullen, Louise
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Giannitsis, Evan ...
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Hammarsten, Ola
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Huber, Kurt
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Krychtiuk, Konst ...
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Mueller, Christi ...
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Thygesen, Kristi ...
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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 ...
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Biomarkers
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Uppsala University