Impact of periprocedural myocardial necrosis on short term clinical outcome

Background

No reliable data whether periprocedural myocardial necrosis (PPN) has same poor prognostic value as periprocedural myocardial infarction (PMI) or not. We aimed to assess the impact of PPN on short term clinical outcome.

Methods

100 patients admitted with non ST elevation acute coronary syndrome and underwent PCI were enrolled. Patients were grouped according to the occurrence of PPN into 2 groups, and were followed for 3 months. Patients with PMI were excluded.

Results

30 patients (30%) had PPN and were associated with higher risks of major adverse cardiac events (MACE) during the hospital and 3 months follow up (43.3% and 66.7% vs. 12.9% and 14.3% respectively; p < 0.001). PPN was more likely to occur in older, diabetic, previously infracted, and heart failure patients (p value: <0.05), in addition to patients who had lengthy and more complex lesions (p value 0.006 and <0.001 respectively). Each unit increase in Modified Gensini Score (MGS) increased odds of procedural complications 1.2 times, (P value 0.046), which in turn increased odds of short term MACE 5.7 times, (P value 0.003).

Conclusions

PPN are associated with poor short term prognosis. PPN occurs more in diabetic, heart failure, infracted patients and those who have complex lesions.