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, Jung Han Yoon, Seung Jea Tahk, Ki Bae Seung, Seung Jung Park, Hyeon Cheol Gwon

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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

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Song, P. S., Song, Y. B., Yang, J. H., Kang, G. H., Hahn, J. Y., Choi, S. H., Choi, J. H., Lee, S. H., Jang, Y., Yoon, J. H., Tahk, S. J., Seung, K. B., Park, S. J., & Gwon, H. C. (2013). Periprocedural myocardial infarction is not associated with an increased risk of long-term cardiac mortality after coronary bifurcation stenting. International Journal of Cardiology, 167(4), 1251-1256. https://doi.org/10.1016/j.ijcard.2012.03.146