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Periprocedural Myocardial Infarction in Contemporary Practice

David W Lee1, Matthew A Cavender1

  • 1Division of Interventional Cardiology, University of North Carolina, 160 Dental Circle, CB 7075, Chapel Hill, NC 27599, USA.

Interventional Cardiology Clinics
|March 6, 2019
PubMed

Insights

Periprocedural myocardial infarction (MI) is uncommon but serious after percutaneous coronary interventions (PCI). Strategies like dual antiplatelet therapy and anticoagulation can reduce its risk.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Periprocedural myocardial infarction (MI) is a rare but significant complication following percutaneous coronary interventions (PCI).
  • It is associated with elevated risks of mortality and morbidity.

Purpose of the Study:

  • To review the causes and therapeutic strategies for reducing periprocedural MI in the context of contemporary PCI.

Main Methods:

  • Literature review of periprocedural MI causes and management.
  • Analysis of therapeutic interventions including antiplatelet therapy, anticoagulation, and embolic protection.

Main Results:

  • Periprocedural MI can result from acute side branch occlusion, distal embolization, slow-flow/no-reflow, abrupt vessel closure, or mechanical issues.
  • Effective strategies include dual antiplatelet therapy, cangrelor, glycoprotein IIb/IIIa inhibitors, various anticoagulants, and embolic protection devices.

Conclusions:

  • Minimizing periprocedural MI requires a multifaceted approach combining pharmacotherapy and device-based interventions.
  • Proactive management is crucial for improving patient outcomes after PCI.
Keywords:
Myocardial infarctionPercutaneous coronary interventionPeriprocedural myocardial infarction

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