title: Periprocedural myocardial infarction during percutaneous coronary intervention in an academic tertiary centre in Johannesburg.
abstract: BACKGROUND
  Percutaneous coronary intervention (PCI) is effective therapy for significant atherosclerotic coronary artery disease. Despite medical and technological advances in PCI, periprocedural myocardial infarction (PMI) remains a common complication. The frequency and factors associated with PMI have been well investigated in the developed world, yet there is a paucity of data from the developing world, especially Sub-Saharan Africa.
  
  
  METHODS
  We prospectively enrolled 153 adult patients undergoing PCI at the Charlotte Maxeke Johannesburg Academic Hospital from the 1st of February 2014 to 31st October 2014. Periprocedural Creatinine Kinase-MB and hs-Troponin I were routinely measured before PCI and at 16-24h post-procedure. The third universal definition of myocardial infarction was used to define a PMI event.
  
  
  RESULTS
  152 participants met the inclusion criteria and were analysed for PMI. 70.4% participants were male. The mean age was 58.8 (SD 10.9) years old. Sixteen (10.5%) participants fulfilled the criteria for PMI. Side branch pinching with preserved TIMI III flow was noted in 62.5% of PMI cases. Duration of procedure (P=0.007), right coronary artery intervention (p=0.042) and total stent length (p=0.045) were independently associated with PMI.
  
  
  CONCLUSIONS
  PMI occurred in 10.5% of cases undergoing PCI. This is consistent with the prevalence of PMI internationally. Larger multicentre studies are required in our demographic region to further define relevant predictors and outcomes associated with PMI.
authors.affiliation: Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Gauteng, South Africa. Electronic address: Nqoba.Tsabedze@wits.ac.za.
authors.forename: Nqoba
authors.initials: N
authors.lastname: Tsabedze
authors.affiliation: Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Gauteng, South Africa.
authors.forename: Keir
authors.initials: K
authors.lastname: McCutcheon
authors.affiliation: Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Gauteng, South Africa.
authors.forename: Lancelot
authors.initials: L
authors.lastname: Mkhwanazi
authors.affiliation: Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Gauteng, South Africa.
authors.forename: Riaz
authors.initials: R
authors.lastname: Garda
authors.affiliation: Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Gauteng, South Africa.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Vachiat
authors.affiliation: Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Gauteng, South Africa.
authors.forename: Rohan
authors.initials: R
authors.lastname: Ramjee
authors.affiliation: Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Gauteng, South Africa.
authors.forename: Jameel
authors.initials: J
authors.lastname: Moosa
authors.affiliation: Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Gauteng, South Africa.
authors.forename: Themba
authors.initials: T
authors.lastname: Maluleke
authors.affiliation: Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Gauteng, South Africa.
authors.forename: Gloria
authors.initials: G
authors.lastname: Mukeshimana
authors.affiliation: Division of Diagnostic Radiography, Department of Radiation Sciences, Faculty of Health Sciences, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Gauteng, South Africa.
authors.forename: Saffiyyah
authors.initials: S
authors.lastname: Karolia
authors.affiliation: Division of Nuclear Medicine and Molecular Imaging, Department of Radiation Sciences, Faculty of Health Sciences, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Gauteng, South Africa.
authors.forename: Dineo
authors.initials: D
authors.lastname: Mpanya
authors.affiliation: Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Gauteng, South Africa.
authors.forename: Pravin
authors.initials: P
authors.lastname: Manga
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D013997:Time Factors
keywords: Coronary artery disease; Percutaneous coronary intervention; Periprocedural myocardial infarction