Periprocedural myocardial injury after elective percutaneous coronary intervention in stable angina pectoris: a tertiary center experience

Abstract

Background: Periprocedural myocardial injury and its clinical signifi cance in stable patients are still under discussion. This subject has been assessed in many studies with different defi nitions, thresholds, and biomarkers for years. This study aimed to determine the clinical outcomes of periprocedural myocardial injury based on latest 4th UDMI guideline defi nitions. Methods: 238 patients who underwent elective percutaneous coronary intervention at single center were retrospectively enrolled. Patients who developed periprocedural myocardial injury were compared with patients with normal troponin values after the procedure for clinical outcomes. Primary clinical endpoints were death, MI, stroke, refractory angina, target vessel revascularization and hospitalization due to acute coronary syndrome at one year. Results: Periprocedural myocardial injury was observed in 67.2% (n = 160) of patients. Number of lesions and stents, total stent length, total stent diameter, post-dilatation, overlapping stents, bifurcation stenting and SYNTAX score were signifi cantly higher in myocardial injury group. Clinical outcomes occurred in 16 patients, 11 of 16 had myocardial injury group, 5 of 16 had control group. No mortality was seen during the follow-up. Postprocedural troponin elevation was not associated with clinical outcomes (11 vs. 5, p = 0,56). Kaplan–Meier curve of clinical end points did not show any separation between the curves (Log rank test, 95% CI, p = 0,71). Conclusion: Stent size and length, post-dilatation, overlapping stents and stenting of bifurcation lesions lead to increase in myocardial injury. Periprocedural myocardial injury in stable angina does not predict clinical outcomes at one year.