PMID- 20850095
OWN - NLM
STAT- MEDLINE
DCOM- 20110301
LR  - 20151119
IS  - 1876-7605 (Electronic)
IS  - 1936-8798 (Linking)
VI  - 3
IP  - 9
DP  - 2010 Sep
TI  - New universal definition of myocardial infarction applicable after complex 
      percutaneous coronary interventions?
PG  - 950-8
LID - 10.1016/j.jcin.2010.06.015 [doi]
AB  - OBJECTIVES: This study aimed to characterize myocardial infarction after 
      percutaneous coronary intervention (PCI) based on cardiac marker elevation as 
      recommended by the new universal definition and on the detection of late 
      gadolinium enhancement (LGE) by cardiovascular magnetic resonance (CMR). It is 
      also assessed whether baseline inflammatory biomarkers are higher in patients 
      developing myocardial injury. BACKGROUND: Cardiovascular magnetic resonance 
      accurately assesses infarct size. Baseline C-reactive protein (CRP) and neopterin 
      predict prognosis after stent implantation. METHODS: Consecutive patients with 
      baseline troponin (Tn) I within normal limits and no LGE in the target vessel 
      underwent baseline and post-PCI CMR. The Tn-I was measured until 24 h after PCI. 
      Serum high-sensitivity CRP and neopterin were assessed before coronary 
      angiography. RESULTS: Of 45 patients, 64 (53 to 72) years of age, 33% developed 
      LGE with infarct size of 0.83 g (interquartile range: 0.32 to 1.30 g). A Tn-I 
      elevation >99% upper reference limit (i.e., myocardial necrosis) (median Tn-I: 
      0.51 mug/l, interquartile range: 0.16 to 1.23) and Tn-I > 3x upper reference limit 
      (i.e., type 4a myocardial infarction [MI]) occurred in 58% and 47% patients, 
      respectively. LGE was undetectable in 42% and 43% of patients with periprocedural 
      myocardial necrosis and type 4a MI, respectively. Agreement between LGE and type 
      4a MI was moderate (kappa = 0.45). The levels of CRP or neopterin did not 
      significantly differ between patients with or without myocardial injury, detected 
      by CMR or according to the new definition (p = NS). CONCLUSIONS: This study 
      reports the lack of substantial agreement between the new universal definition 
      and CMR for the diagnosis of small-size periprocedural myocardial damage after 
      complex PCI. Baseline levels of CRP or neopterin were not predictive for the 
      development of periprocedural myocardial damage.
CI  - Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Locca, Didier
AU  - Locca D
AD  - CMR Unit, Royal Brompton Hospital, London; Imperial College, London, UK. 
      c.dimario@rbht.nhs.uk
FAU - Bucciarelli-Ducci, Chiara
AU  - Bucciarelli-Ducci C
FAU - Ferrante, Giuseppe
AU  - Ferrante G
FAU - La Manna, Alessio
AU  - La Manna A
FAU - Keenan, Niall G
AU  - Keenan NG
FAU - Grasso, Agata
AU  - Grasso A
FAU - Barlis, Peter
AU  - Barlis P
FAU - Del Furia, Francesca
AU  - Del Furia F
FAU - Prasad, Sanjay K
AU  - Prasad SK
FAU - Kaski, Juan Carlos
AU  - Kaski JC
FAU - Pennell, Dudley J
AU  - Pennell DJ
FAU - Di Mario, Carlo
AU  - Di Mario C
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - JACC Cardiovasc Interv
JT  - JACC. Cardiovascular interventions
JID - 101467004
RN  - 0 (Biomarkers)
RN  - 670-65-5 (Neopterin)
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
CIN - JACC Cardiovasc Interv. 2010 Sep;3(9):959-62. PMID: 20850096
MH  - Aged
MH  - *Angioplasty, Balloon, Coronary
MH  - Biomarkers/blood
MH  - C-Reactive Protein/*metabolism
MH  - Coronary Angiography/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/blood/*diagnosis/therapy
MH  - Neopterin/*blood
MH  - Prognosis
MH  - Prospective Studies
MH  - ROC Curve
MH  - Treatment Outcome
EDAT- 2010/09/21 06:00
MHDA- 2011/03/02 06:00
CRDT- 2010/09/21 06:00
PHST- 2010/04/04 00:00 [received]
PHST- 2010/06/02 00:00 [revised]
PHST- 2010/06/09 00:00 [accepted]
PHST- 2010/09/21 06:00 [entrez]
PHST- 2010/09/21 06:00 [pubmed]
PHST- 2011/03/02 06:00 [medline]
AID - S1936-8798(10)00512-1 [pii]
AID - 10.1016/j.jcin.2010.06.015 [doi]
PST - ppublish
SO  - JACC Cardiovasc Interv. 2010 Sep;3(9):950-8. doi: 10.1016/j.jcin.2010.06.015.