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IS MYOCARDIAL INFARCTION AFTER PERCUTANEOUS CORONARY INTERVENTION A RELIABLE MEASURE OF STENT SAFETY?
E69 JACC March 27, 2012 Volume 59, Issue 13
ACC-i2 with TCT IS MYOCARDIAL INFARCTION AFTER PERCUTANEOUS CORONARY INTERVENTION A RELIABLE MEASURE OF STENT SAFETY? i2 Poster Contributions McCormick Place South, Hall A Saturday, March 24, 2012, 9:30 a.m.-Noon
Session Title: Outcomes of Patients Treated with PCI Abstract Category: 16. PCI - DES (clinical/outcomes) Presentation Number: 2523-242 Authors: Sudhakar Sattur, Judith Boura, Pam Orshaw, Kishore Harjai, Guthrie-Robert Packer Hospital, Sayre, PA, USA Background: In randomized stent trials, MI occurring after PCI is a measure of stent safety. MI is often defined by cardiac enzyme elevation or diagnostic EKG changes regardless of the angiographic location of the culprit lesion. Hence, the relation of post-PCI MI to the stented vessel cannot be ascertained. Methods: In 1228 patients presenting with STEMI (n=554) or NSTEMI (n=674) who underwent successful stenting, we prospectively assessed the incidence of re-MI (defined per NCDR 4.4) and the location of the culprit lesion. Results: At a mean follow-up duration of 1285 ± 706 days, 102 patients suffered re-MI, including 72 who underwent follow-up angiography. The culprit lesion causing re-MI was noted to be in the stented vessel in 48 (47%), and in a different vessel in 24 (24%) patients (see figure). Conclusion: A significant number of MI occurring after PCI are unrelated to the stented vessel. Hence, the use of MI - without angiographic confirmation of the culprit lesion - as a safety end point in stent trials should be abandoned. Future randomized stent studies should uniformly report target vessel failure, which includes only those MI events that occur in the stented vessel.
ACC-i2 with TCT IS MYOCARDIAL INFARCTION AFTER PERCUTANEOUS CORONARY INTERVENTION A RELIABLE MEASURE OF STENT SAFETY? i2 Poster Contributions McCormick Place South, Hall A Saturday, March 24, 2012, 9:30 a.m.-Noon
Session Title: Outcomes of Patients Treated with PCI Abstract Category: 16. PCI - DES (clinical/outcomes) Presentation Number: 2523-242 Authors: Sudhakar Sattur, Judith Boura, Pam Orshaw, Kishore Harjai, Guthrie-Robert Packer Hospital, Sayre, PA, USA Background: In randomized stent trials, MI occurring after PCI is a measure of stent safety. MI is often defined by cardiac enzyme elevation or diagnostic EKG changes regardless of the angiographic location of the culprit lesion. Hence, the relation of post-PCI MI to the stented vessel cannot be ascertained. Methods: In 1228 patients presenting with STEMI (n=554) or NSTEMI (n=674) who underwent successful stenting, we prospectively assessed the incidence of re-MI (defined per NCDR 4.4) and the location of the culprit lesion. Results: At a mean follow-up duration of 1285 ± 706 days, 102 patients suffered re-MI, including 72 who underwent follow-up angiography. The culprit lesion causing re-MI was noted to be in the stented vessel in 48 (47%), and in a different vessel in 24 (24%) patients (see figure). Conclusion: A significant number of MI occurring after PCI are unrelated to the stented vessel. Hence, the use of MI - without angiographic confirmation of the culprit lesion - as a safety end point in stent trials should be abandoned. Future randomized stent studies should uniformly report target vessel failure, which includes only those MI events that occur in the stented vessel.