Patterns of Cardiac Marker Surveillance After Elective Percutaneous Coronary Intervention and Implications for the Use of Periprocedural Myocardial Infarction as a Quality Metric: A Report From the National Cardiovascular Data Registry (NCDR)

摘要

With recent advances m catheter technology and adjunctive pharmacotherapy, percutaneous coronary intervention (PCI) has achieved high procedural success rates and is a widely used means of myocardial revascularization among patients with coronary artery disease. Outcomes after PCI vary depending on patient selection, angiographic complexity, operator skill, and institutional care practices. Periprocedural myocardial infarction (MI) is detected in up to 30% of patients undergoing PCI, depending on the marker tested, population studied, and threshold for diagnosis based upon the degree of marker elevation (1). In clinical trials of PCI-related therapies, periprocedural MI is commonly adjudicated as an outcome measure and has been shown to be significantly associated with increased long-term mortality (2-5). However, there is no clearly defined threshold at which this increase in risk and definition of "myocardial infarction" converge#