title: Association of periprocedural myocardial infarction with long-term survival in patients treated with coronary revascularization therapy of chronic total occlusion.
abstract: OBJECTIVE
  To evaluate the impact of periprocedural myocardial infarction (PMI) on long-term survival after coronary revascularization in patients with chronic total occlusion (CTO).
  
  
  BACKGROUND
  Little is known about the clinical impact of PMI on long-term cardiac mortality after CTO revascularization in patients with stable angina.
  
  
  METHODS
  We analyzed data from 927 patients with CTO and stable angina who were treated with coronary artery bypass grafting (CABG, n = 367) or percutaneous coronary intervention (PCI, n = 560). PMI was defined as a peak CK-MB ≥ 3 times the upper limit of normal (ULN) after PCI or a CK-MB ≥ 5 times the ULN after CABG. The primary outcome was cardiac death in patients with PMI (PMI group, n = 118 [12.7%]) or without PMI (no-PMI group, n = 809 [87.3%]) after revascularization.
  
  
  RESULTS
  During a median follow-up of 42 months, PMI occurred in 118 patients (12.7% of the overall study population). Fifty-nine patients treated with PCI (10.5% of PCI subgroup) and 59 patients treated with CABG (16.1% of CABG subgroup) suffered from PMI. In multivariate analysis, the PMI group and the no-PMI group had a similar incidence of cardiac death (hazard ratio [HR] 0.57; 95% confidence interval [CI] 0.20 to 1.62; P = 0.29).
  
  
  CONCLUSIONS
  PMI may not be associated with increased cardiac mortality after coronary revascularization in patients with stable CTO. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Jang
authors.affiliation: Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jeong Hoon
authors.initials: JH
authors.lastname: Yang
authors.affiliation: Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Seung-Hyuk
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Young Bin
authors.initials: YB
authors.lastname: Song
authors.affiliation: Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Joo-Yong
authors.initials: JY
authors.lastname: Hahn
authors.affiliation: Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Wook Sung
authors.initials: WS
authors.lastname: Kim
authors.affiliation: Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Young Tak
authors.initials: YT
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Medicine, Konkuk University Medical Center, Seoul, Republic of Korea.
authors.forename: Bum-Sung
authors.initials: BS
authors.lastname: Kim
authors.affiliation: Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Hyeon-Cheol
authors.initials: HC
authors.lastname: Gwon
mesh_terms: D002908:Chronic Disease; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
keywords: CTO revascularization; clinical outcome; peri-procedural MI