title: Detecting Periprocedural Myocardial Infarction in Contemporary Percutaneous Coronary Intervention Trials.
abstract: This study sought to investigate the differences in detecting (e.g., triggering) periprocedural myocardial infarction (PMI) among 3 current definitions.
  
  
  
  PMI is a frequent component of primary endpoints in coronary device trials. Identification of all potential suspected events is critical for accurate event ascertainment. Automatic triggers based on study databases prevent underreporting of events.
  
  
  
  We generated automated algorithms to trigger PMI based on each definition and compared results using data from the RESOLUTE all comers trial.
  
  
  
  The operationalization of current PMI definitions was achieved by defining programmable algorithms used to interrogate the study database. From a total of 636 PMI triggers, we identified 234 for the World Health Organization extended definition, 382 for the Third Universal definition, and 216 for the Society for Cardiovascular Angiography and Interventions definition. Differences among the biomarkers used, different cutoff values, and in the hierarchy among biomarkers within definitions, yielded a different number of triggers, and identified unique triggers for each definition. Only 38 triggers were consistently identified by all definitions. Availability of ECG data, eCRF data on clinical presentation, and the reporting of >2 post-procedural values of the same biomarker influenced considerably the number of PMI triggers identified.
  
  
  
  PMI definitions are not interchangeable. The number of triggers identified and consequently the potential number of events varies significantly, highlighting the importance of rigorous methodology when PMI is a component of a powered endpoint. Emphasis on collection of biomarkers, ECG data, and clinical status at baseline may improve the correct identification of PMI triggers.
authors.affiliation: Cardialysis Core Laboratories and Clinical Trial Management, Rotterdam, the Netherlands; Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Ernest
authors.initials: E
authors.lastname: Spitzer
authors.affiliation: Cardialysis Core Laboratories and Clinical Trial Management, Rotterdam, the Netherlands.
authors.forename: Ton
authors.initials: T
authors.lastname: de Vries
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Rafael
authors.initials: R
authors.lastname: Cavalcante
authors.affiliation: Cardialysis Core Laboratories and Clinical Trial Management, Rotterdam, the Netherlands.
authors.forename: Marieke
authors.initials: M
authors.lastname: Tuinman
authors.affiliation: Cardialysis Core Laboratories and Clinical Trial Management, Rotterdam, the Netherlands.
authors.forename: Tessa
authors.initials: T
authors.lastname: Rademaker-Havinga
authors.affiliation: Cardialysis Core Laboratories and Clinical Trial Management, Rotterdam, the Netherlands.
authors.forename: Maaike
authors.initials: M
authors.lastname: Alkema
authors.affiliation: Cardialysis Core Laboratories and Clinical Trial Management, Rotterdam, the Netherlands.
authors.forename: Marie-Angele
authors.initials: MA
authors.lastname: Morel
authors.affiliation: Cardialysis Core Laboratories and Clinical Trial Management, Rotterdam, the Netherlands; Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Osama I
authors.initials: OI
authors.lastname: Soliman
authors.affiliation: Cardialysis Core Laboratories and Clinical Trial Management, Rotterdam, the Netherlands; Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.affiliation: European Cardiovascular Research Institute, Rotterdam, the Netherlands.
authors.forename: Gerrit-Anne
authors.initials: GA
authors.lastname: van Es
authors.affiliation: European Cardiovascular Research Institute, Rotterdam, the Netherlands.
authors.forename: Jan G P
authors.initials: JGP
authors.lastname: Tijssen
authors.affiliation: Cardialysis Core Laboratories and Clinical Trial Management, Rotterdam, the Netherlands; Department of Cardiology, Cork University Hospital, Cork, Ireland.
authors.forename: Eugene
authors.initials: E
authors.lastname: McFadden
authors.affiliation: International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom. Electronic address: patrick.w.j.c.serruys@gmail.com.
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D000465:Algorithms; D015415:Biomarkers / Q000097:blood; D002986:Clinical Trials as Topic / Q000379:methods*; D017023:Coronary Angiography; D057225:Data Mining / Q000379:methods*; D016208:Databases, Factual; D004562:Electrocardiography; D019317:Evidence-Based Medicine; D006801:Humans; D009203:Myocardial Infarction / Q000097:blood / Q000145:classification / Q000175:diagnosis* / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012107:Research Design; D012307:Risk Factors; D009626:Terminology as Topic; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers
keywords: clinical trial; percutaneous coronary intervention; periprocedural myocardial infarction