Periprocedural myocardial infarction is not associated with an increased risk of long-term cardiac mortality after coronary bifurcation stenting

Pil Sang Song, Young Bin Song, Jeong Hoon Yang, Gu Hyun Kang, Joo Yong Hahn, Seung Hyuk Choi, Jin Ho Choi, Sang Hoon Lee, Yangsoo Jang, Junghan Yoon, Seung Jea Tahk, Ki Bae Seung, Seung Jung Park, Hyeon Cheol Gwon

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Debate continues over the importance of periprocedural myocardial infarction (PMI) after percutaneous coronary intervention (PCI). We evaluated the prognostic significance of PMI in patients undergoing PCI for bifurcation lesions. Methods: Between January 2004 and June 2006, patients from 16 centers who received non-left main bifurcation lesion PCIs were enrolled. PMI was defined as a peak creatine kinase-myocardial band (CK-MB) ≥ 3 times the upper limit of normal after PCI. We compared long-term cardiac mortality between patients with and without PMI. Results: Among the 1188 patients, PMI occurred in 119 (10.0%). Left ventricular ejection fraction < 50% (adjusted hazard ratio [HR]: 2.08, 95% confidence interval [CI]: 1.13-3.82, p = 0.018), multi-vessel coronary artery disease (adjusted HR: 2.28, 95% CI: 1.36-3.81, p = 0.002), and PCI-related acute closure in a side branch (adjusted HR: 3.34, 95% CI: 1.23-9.02, p = 0.018) were the significant risk factors for PMI. During the median follow-up of 22.7 months, the unadjusted rate of long-term cardiac mortality was significantly higher in patients with PMI than in those without PMI (2.5% vs 0.7%, p = 0.026). After multivariable adjustment, the relationship between PMI and short-term (≤ 30 day) cardiac mortality was significant (adjusted HR: 12.32, 95% CI: 1.07-141.37, p = 0.044). However, PMI was not an independent prognostic factor of long-term cardiac mortality (adjusted HR: 2.59, 95% CI: 0.62-10.85, p = 0.20). Conclusions: PMI occurs in patients with a higher prevalence of adverse cardiac risks and predicts short-term but not long-term cardiac mortality in patients undergoing bifurcation lesion PCI.

Original languageEnglish
Pages (from-to)1251-1256
Number of pages6
JournalInternational Journal of Cardiology
Volume167
Issue number4
DOIs
Publication statusPublished - 2013 Aug 20

Fingerprint

Myocardial Infarction
Mortality
Percutaneous Coronary Intervention
Confidence Intervals
MB Form Creatine Kinase
Stroke Volume
Coronary Artery Disease

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Song, Pil Sang ; Song, Young Bin ; Yang, Jeong Hoon ; Kang, Gu Hyun ; Hahn, Joo Yong ; Choi, Seung Hyuk ; Choi, Jin Ho ; Lee, Sang Hoon ; Jang, Yangsoo ; Yoon, Junghan ; Tahk, Seung Jea ; Seung, Ki Bae ; Park, Seung Jung ; Gwon, Hyeon Cheol. / Periprocedural myocardial infarction is not associated with an increased risk of long-term cardiac mortality after coronary bifurcation stenting. In: International Journal of Cardiology. 2013 ; Vol. 167, No. 4. pp. 1251-1256.
@article{2b9537c782654dbfae978851f1217519,
title = "Periprocedural myocardial infarction is not associated with an increased risk of long-term cardiac mortality after coronary bifurcation stenting",
abstract = "Background: Debate continues over the importance of periprocedural myocardial infarction (PMI) after percutaneous coronary intervention (PCI). We evaluated the prognostic significance of PMI in patients undergoing PCI for bifurcation lesions. Methods: Between January 2004 and June 2006, patients from 16 centers who received non-left main bifurcation lesion PCIs were enrolled. PMI was defined as a peak creatine kinase-myocardial band (CK-MB) ≥ 3 times the upper limit of normal after PCI. We compared long-term cardiac mortality between patients with and without PMI. Results: Among the 1188 patients, PMI occurred in 119 (10.0{\%}). Left ventricular ejection fraction < 50{\%} (adjusted hazard ratio [HR]: 2.08, 95{\%} confidence interval [CI]: 1.13-3.82, p = 0.018), multi-vessel coronary artery disease (adjusted HR: 2.28, 95{\%} CI: 1.36-3.81, p = 0.002), and PCI-related acute closure in a side branch (adjusted HR: 3.34, 95{\%} CI: 1.23-9.02, p = 0.018) were the significant risk factors for PMI. During the median follow-up of 22.7 months, the unadjusted rate of long-term cardiac mortality was significantly higher in patients with PMI than in those without PMI (2.5{\%} vs 0.7{\%}, p = 0.026). After multivariable adjustment, the relationship between PMI and short-term (≤ 30 day) cardiac mortality was significant (adjusted HR: 12.32, 95{\%} CI: 1.07-141.37, p = 0.044). However, PMI was not an independent prognostic factor of long-term cardiac mortality (adjusted HR: 2.59, 95{\%} CI: 0.62-10.85, p = 0.20). Conclusions: PMI occurs in patients with a higher prevalence of adverse cardiac risks and predicts short-term but not long-term cardiac mortality in patients undergoing bifurcation lesion PCI.",
author = "Song, {Pil Sang} and Song, {Young Bin} and Yang, {Jeong Hoon} and Kang, {Gu Hyun} and Hahn, {Joo Yong} and Choi, {Seung Hyuk} and Choi, {Jin Ho} and Lee, {Sang Hoon} and Yangsoo Jang and Junghan Yoon and Tahk, {Seung Jea} and Seung, {Ki Bae} and Park, {Seung Jung} and Gwon, {Hyeon Cheol}",
year = "2013",
month = "8",
day = "20",
doi = "10.1016/j.ijcard.2012.03.146",
language = "English",
volume = "167",
pages = "1251--1256",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",
number = "4",

}

Song, PS, Song, YB, Yang, JH, Kang, GH, Hahn, JY, Choi, SH, Choi, JH, Lee, SH, Jang, Y, Yoon, J, Tahk, SJ, Seung, KB, Park, SJ & Gwon, HC 2013, 'Periprocedural myocardial infarction is not associated with an increased risk of long-term cardiac mortality after coronary bifurcation stenting', International Journal of Cardiology, vol. 167, no. 4, pp. 1251-1256. https://doi.org/10.1016/j.ijcard.2012.03.146

Periprocedural myocardial infarction is not associated with an increased risk of long-term cardiac mortality after coronary bifurcation stenting. / Song, Pil Sang; Song, Young Bin; Yang, Jeong Hoon; Kang, Gu Hyun; Hahn, Joo Yong; Choi, Seung Hyuk; Choi, Jin Ho; Lee, Sang Hoon; Jang, Yangsoo; Yoon, Junghan; Tahk, Seung Jea; Seung, Ki Bae; Park, Seung Jung; Gwon, Hyeon Cheol.

In: International Journal of Cardiology, Vol. 167, No. 4, 20.08.2013, p. 1251-1256.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Periprocedural myocardial infarction is not associated with an increased risk of long-term cardiac mortality after coronary bifurcation stenting

AU - Song, Pil Sang

AU - Song, Young Bin

AU - Yang, Jeong Hoon

AU - Kang, Gu Hyun

AU - Hahn, Joo Yong

AU - Choi, Seung Hyuk

AU - Choi, Jin Ho

AU - Lee, Sang Hoon

AU - Jang, Yangsoo

AU - Yoon, Junghan

AU - Tahk, Seung Jea

AU - Seung, Ki Bae

AU - Park, Seung Jung

AU - Gwon, Hyeon Cheol

PY - 2013/8/20

Y1 - 2013/8/20

N2 - Background: Debate continues over the importance of periprocedural myocardial infarction (PMI) after percutaneous coronary intervention (PCI). We evaluated the prognostic significance of PMI in patients undergoing PCI for bifurcation lesions. Methods: Between January 2004 and June 2006, patients from 16 centers who received non-left main bifurcation lesion PCIs were enrolled. PMI was defined as a peak creatine kinase-myocardial band (CK-MB) ≥ 3 times the upper limit of normal after PCI. We compared long-term cardiac mortality between patients with and without PMI. Results: Among the 1188 patients, PMI occurred in 119 (10.0%). Left ventricular ejection fraction < 50% (adjusted hazard ratio [HR]: 2.08, 95% confidence interval [CI]: 1.13-3.82, p = 0.018), multi-vessel coronary artery disease (adjusted HR: 2.28, 95% CI: 1.36-3.81, p = 0.002), and PCI-related acute closure in a side branch (adjusted HR: 3.34, 95% CI: 1.23-9.02, p = 0.018) were the significant risk factors for PMI. During the median follow-up of 22.7 months, the unadjusted rate of long-term cardiac mortality was significantly higher in patients with PMI than in those without PMI (2.5% vs 0.7%, p = 0.026). After multivariable adjustment, the relationship between PMI and short-term (≤ 30 day) cardiac mortality was significant (adjusted HR: 12.32, 95% CI: 1.07-141.37, p = 0.044). However, PMI was not an independent prognostic factor of long-term cardiac mortality (adjusted HR: 2.59, 95% CI: 0.62-10.85, p = 0.20). Conclusions: PMI occurs in patients with a higher prevalence of adverse cardiac risks and predicts short-term but not long-term cardiac mortality in patients undergoing bifurcation lesion PCI.

AB - Background: Debate continues over the importance of periprocedural myocardial infarction (PMI) after percutaneous coronary intervention (PCI). We evaluated the prognostic significance of PMI in patients undergoing PCI for bifurcation lesions. Methods: Between January 2004 and June 2006, patients from 16 centers who received non-left main bifurcation lesion PCIs were enrolled. PMI was defined as a peak creatine kinase-myocardial band (CK-MB) ≥ 3 times the upper limit of normal after PCI. We compared long-term cardiac mortality between patients with and without PMI. Results: Among the 1188 patients, PMI occurred in 119 (10.0%). Left ventricular ejection fraction < 50% (adjusted hazard ratio [HR]: 2.08, 95% confidence interval [CI]: 1.13-3.82, p = 0.018), multi-vessel coronary artery disease (adjusted HR: 2.28, 95% CI: 1.36-3.81, p = 0.002), and PCI-related acute closure in a side branch (adjusted HR: 3.34, 95% CI: 1.23-9.02, p = 0.018) were the significant risk factors for PMI. During the median follow-up of 22.7 months, the unadjusted rate of long-term cardiac mortality was significantly higher in patients with PMI than in those without PMI (2.5% vs 0.7%, p = 0.026). After multivariable adjustment, the relationship between PMI and short-term (≤ 30 day) cardiac mortality was significant (adjusted HR: 12.32, 95% CI: 1.07-141.37, p = 0.044). However, PMI was not an independent prognostic factor of long-term cardiac mortality (adjusted HR: 2.59, 95% CI: 0.62-10.85, p = 0.20). Conclusions: PMI occurs in patients with a higher prevalence of adverse cardiac risks and predicts short-term but not long-term cardiac mortality in patients undergoing bifurcation lesion PCI.

UR - http://www.scopus.com/inward/record.url?scp=84881482187&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84881482187&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2012.03.146

DO - 10.1016/j.ijcard.2012.03.146

M3 - Article

C2 - 22494861

AN - SCOPUS:84881482187

VL - 167

SP - 1251

EP - 1256

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

IS - 4

ER -