PMID- 21205592
OWN - NLM
STAT- MEDLINE
DCOM- 20110422
LR  - 20161125
IS  - 1969-6213 (Electronic)
IS  - 1774-024X (Linking)
VI  - 6
IP  - 6
DP  - 2011 Jan
TI  - Myocardial injury following coronary artery surgery versus angioplasty (MICASA): 
      a randomised trial using biochemical markers and cardiac magnetic resonance 
      imaging.
PG  - 703-10
LID - EIJV6I6A119 [pii]
LID - 10.4244/EIJV6I6A119 [doi]
AB  - AIMS: To compare the frequency and extent of Troponin I and late gadolinium 
      enhancement (LGE) cardiac magnetic resonance (CMR) defined injury following PCI 
      compared with CABG in patients with multivessel and/or left main coronary artery 
      disease (CAD), and interpret these finding in light of the new ESC/ACCF/AHA/WHF 
      Task Force definitions for necrosis and infarction. METHODS AND RESULTS: 
      Prospective, registered, single centre randomised controlled trial. Eighty 
      patients with 3 vessel CAD (>/= 50% stenoses), or 2 vessel CAD including a type C 
      lesion in the LAD, and/or left main disease were enrolled. Mean SYNTAX and 
      EuroSCOREs were similar for both groups. Forty patients underwent PCI with drug 
      eluting stents and 39 underwent CABG (one died prior to CABG). In the PCI group 
      6/38 (15.8%) patients had LGE, compared with 9/32 (28.1%) CABG patients (p = 
      0.25). Using the new Task Force definitions, necrosis occurred in 30/40 (75%) PCI 
      patients and 35/35 (100%) CABG patients (p = 0.001), whilst infarction occurred 
      in 30/40 (75%) PCI patients and 9/32 (28.1%) CABG patients (p = 0.0001). 
      CONCLUSIONS: Periprocedural necrosis according to the Task Force definition was 
      significantly lower in the PCI group, and universal in the CABG group. The 
      incidence and extent of CMR defined infarction following PCI did not differ 
      compared with CABG. This demonstrates that PCI can achieve revascularisation in 
      complex patients without increased procedural myocardial damage.
FAU - van Gaal, William J
AU  - van Gaal WJ
AD  - Oxford Heart Centre, John Radcliffe Hospital, Oxford, UK. 
      william.vargaal@nh.org.au
FAU - Arnold, Jayanth R
AU  - Arnold JR
FAU - Testa, Luca
AU  - Testa L
FAU - Karamitsos, Theo
AU  - Karamitsos T
FAU - Lim, Chris C S
AU  - Lim CC
FAU - Ponnuthurai, Francis A
AU  - Ponnuthurai FA
FAU - Petersen, Steffen
AU  - Petersen S
FAU - Francis, Jane M
AU  - Francis JM
FAU - Selvanayagam, Joseph
AU  - Selvanayagam J
FAU - Sayeed, Rana
AU  - Sayeed R
FAU - West, Nicholas
AU  - West N
FAU - Westaby, Steve
AU  - Westaby S
FAU - Neubauer, Stefan
AU  - Neubauer S
FAU - Banning, Adrian P
AU  - Banning AP
LA  - eng
SI  - ISRCTN/ISRCTN25699844
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - France
TA  - EuroIntervention
JT  - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on 
      Interventional Cardiology of the European Society of Cardiology
JID - 101251040
RN  - 0 (Biomarkers)
RN  - 0 (Contrast Media)
RN  - 0 (Troponin I)
RN  - EC 2.7.3.2 (Creatine Kinase, MB Form)
SB  - IM
MH  - Aged
MH  - Angioplasty, Balloon, Coronary/*adverse effects/instrumentation
MH  - Biomarkers/blood
MH  - Chi-Square Distribution
MH  - Contrast Media
MH  - Coronary Angiography
MH  - Coronary Artery Bypass/*adverse effects
MH  - Coronary Stenosis/diagnostic imaging/physiopathology/surgery/*therapy
MH  - Creatine Kinase, MB Form/*blood
MH  - Drug-Eluting Stents
MH  - Electrocardiography
MH  - England
MH  - Female
MH  - Heart Diseases/blood/*diagnosis/etiology/pathology/physiopathology
MH  - Humans
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - Necrosis
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Stroke Volume
MH  - Time Factors
MH  - Treatment Outcome
MH  - Troponin I/*blood
MH  - Ventricular Function, Left
EDAT- 2011/01/06 06:00
MHDA- 2011/04/26 06:00
CRDT- 2011/01/06 06:00
PHST- 2011/01/06 06:00 [entrez]
PHST- 2011/01/06 06:00 [pubmed]
PHST- 2011/04/26 06:00 [medline]
AID - EIJV6I6A119 [pii]
AID - 10.4244/EIJV6I6A119 [doi]
PST - ppublish
SO  - EuroIntervention. 2011 Jan;6(6):703-10. doi: 10.4244/EIJV6I6A119.