Incidence of procedural related myocardial infarction following percutaneous coronary intervention. A matter of definitions.
OBJECTIVE
To define the incidence of procedural related myocardial infarction (MI) in patients undergoing elective PCI using different definitions of MI, especially focusing on the criteria proposed by the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) for the definition of MI.


RESULTS
A prospective study including 220 patients scheduled for elective PCI. To be included, preprocedural values of the following biochemical markers had to be normal; aspartate aminotransferase (AST), creatine kinase (CK) , creatinine kinase MB fraction (mass concentration) (CK-MBmass) and cardiac troponin I (cTnI).According to different definitions the incidence of procedural related MI following PCI differed from 0,9% (previous WHO definition) to 26,4% (ESC/ACC criteria). Other commonly used definitions of MI resulted in incidence rates between these values.


CONCLUSIONS
Depending on definitions used the incidence of procedural MI following elective PCI may vary by a factor of 30. This makes comparison of MI rates between institutions difficult. Furthermore, outcome and conclusions in interventional studies with MI as an endpoint may differ according to definitions used for procedural MI. A clear description of the applied definition of procedural MI following PCI is mandatory. For epidemiological and other reasons a separate ICD code is proposed for MIs caused by PCI.
Wiseth
Rune
R
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
Hegbom
Knut
K
Slette
Morten
M
Asberg
Arne
A
Vik-Mo
Harald
H