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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)
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: Revie...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9344934/ https://www.ncbi.nlm.nih.gov/pubmed/35603440 http://dx.doi.org/10.1080/1354750X.2022.2055792 |
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author | Mair, Johannes Jaffe, Allan Lindahl, Bertil Mills, Nicholas Möckel, Martin Cullen, Louise Giannitsis, Evangelos Hammarsten, Ola Huber, Kurt Krychtiuk, Konstantin Mueller, Christian Thygesen, Kristian |
author_facet | Mair, Johannes Jaffe, Allan Lindahl, Bertil Mills, Nicholas Möckel, Martin Cullen, Louise Giannitsis, Evangelos Hammarsten, Ola Huber, Kurt Krychtiuk, Konstantin Mueller, Christian Thygesen, Kristian |
author_sort | Mair, Johannes |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9344934 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-93449342022-08-03 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) Mair, Johannes Jaffe, Allan Lindahl, Bertil Mills, Nicholas Möckel, Martin Cullen, Louise Giannitsis, Evangelos Hammarsten, Ola Huber, Kurt Krychtiuk, Konstantin Mueller, Christian Thygesen, Kristian Biomarkers Review 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. Taylor & Francis 2022-05-26 /pmc/articles/PMC9344934/ /pubmed/35603440 http://dx.doi.org/10.1080/1354750X.2022.2055792 Text en © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Mair, Johannes Jaffe, Allan Lindahl, Bertil Mills, Nicholas Möckel, Martin Cullen, Louise Giannitsis, Evangelos Hammarsten, Ola Huber, Kurt Krychtiuk, Konstantin Mueller, Christian Thygesen, Kristian 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) |
title | 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) |
title_full | 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) |
title_fullStr | 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) |
title_full_unstemmed | 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) |
title_short | 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) |
title_sort | 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) |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9344934/ https://www.ncbi.nlm.nih.gov/pubmed/35603440 http://dx.doi.org/10.1080/1354750X.2022.2055792 |
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clinicalapproachtodiagnosingperiproceduralmyocardialinfarctionafterpercutaneouscoronaryinterventionsaccordingtothefourthuniversaldefinitionofmyocardialinfarctionfromthestudygrouponbiomarkersoftheeuropeansocietyofcardiologyescassociationforacutecardiovascu AT muellerchristian clinicalapproachtodiagnosingperiproceduralmyocardialinfarctionafterpercutaneouscoronaryinterventionsaccordingtothefourthuniversaldefinitionofmyocardialinfarctionfromthestudygrouponbiomarkersoftheeuropeansocietyofcardiologyescassociationforacutecardiovascu AT thygesenkristian clinicalapproachtodiagnosingperiproceduralmyocardialinfarctionafterpercutaneouscoronaryinterventionsaccordingtothefourthuniversaldefinitionofmyocardialinfarctionfromthestudygrouponbiomarkersoftheeuropeansocietyofcardiologyescassociationforacutecardiovascu |