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Relationship Between the Completeness of Revascularization and Myocardial Injury in Patients Treated With

Luca Paolucci1, Fabio Mangiacapra1, Michele Mattia Viscusi1

  • 1Department of Cardiovascular Sciences, Campus-Biomedico University, Rome, Italy.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|October 27, 2022
PubMed

Insights

Incomplete revascularization after percutaneous coronary intervention (PCI) combined with elevated cardiac troponin (cTn) significantly increases major adverse cardiac events (MACE). Patients with incomplete revascularization are a high-risk subgroup needing closer monitoring.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Clinical outcomes of periprocedural myocardial injury with incomplete revascularization (IR) post-percutaneous coronary intervention (PCI) remain understudied.
  • Understanding the impact of myocardial injury and revascularization completeness is crucial for patient management.

Purpose of the Study:

  • To evaluate the association between post-PCI cardiac troponin (cTn) elevation thresholds, revascularization completeness, and long-term clinical outcomes.
  • To identify high-risk patient subgroups following PCI.

Main Methods:

  • 1061 patients undergoing PCI for stable coronary artery disease were analyzed.
  • Incomplete revascularization (IR) was defined by a residual SYNTAX score (rSS) >4.
  • Myocardial injury thresholds were set at 5×, 35×, and 70× the upper reference limit (URL) of baseline cTn.

Main Results:

  • Incomplete revascularization (IR) occurred in 23.4% of patients; major myocardial injury in 50.9%.
  • High preprocedural SYNTAX scores increased the risk of IR and myocardial injury.
  • IR combined with cTn elevation >35× URL or >70× URL significantly increased the risk of major adverse cardiac events (MACE) at two years.

Conclusions:

  • Periprocedural myocardial injury is strongly linked to MACE in PCI patients with IR.
  • Patients with incomplete revascularization after PCI represent a high-risk group.
  • Further investigation into managing myocardial injury in IR patients is warranted.
Abstract

Keywords:
Coronary artery diseaseMyocardial injuryPercutaneous coronary intervention

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