Periprocedural myocardial infarction and injury

Area of Science:

• Cardiology
• Clinical Practice

Background:

• Periprocedural myocardial infarction (PMI) and injury are increasingly recognized in cardiac and non-cardiac procedures.
• Diverse definitions for PMI diagnosis exist, complicating clinical settings and research.

Purpose of the Study:

• To highlight the challenges posed by varied PMI diagnostic criteria.
• To emphasize the need for universally accepted thresholds for cardiac biomarkers and ancillary criteria for accurate PMI diagnosis.

Main Methods:

• Review of existing definitions and clinical evidence for PMI.
• Analysis of the prognostic significance of cardiac biomarker elevation based on the 4th Universal Definition of Myocardial Infarction.

Main Results:

• Elevations in cardiac biomarkers align with the 4th Universal Definition of Myocardial Infarction, correlating with increased mortality and cardiovascular events.
• PMI is acknowledged to have high incidence and adverse outcomes in Transcatheter Aortic Valve Implantation.
• Emerging research highlights PMI significance in non-cardiac surgery.

Conclusions:

• Standardized PMI definitions are crucial for consistent clinical practice and reliable clinical trial interpretation.
• Accurate PMI diagnosis is vital for risk stratification and management, particularly in high-risk procedures like TAVI and non-cardiac surgery.