The clinical significance of procedural myocardial infarction in stable ischemic heart disease patients and implications for interpretation of Ischemia trial a registry analysis

Abstract Background The definition, incidence, and clinical significance of procedural myocardial infarction (MI) remains controversial. Interpretations from landmark trials such as “Ischemia” was found to be sensitive the definition MI used (1). Purpose Evaluation incidence MIs in our institution according standard definitions Society Cardiovascular Angiography & Intervention (SCAI) (2), Fourth Universal Definition Myocardial Infarction (UDMI) (3) Ischemia trial (4) whether they predicted major adverse cardiovascular events (MACE) validate relevance these definitions. Moreover, study also explored possibility HS-troponin alone could predict MACE thereby simplifying context its wide-spread availability role a biochemical marker damage. Methods We analysed ECGs, coronary angiograms next day HS troponin-I results on consecutive patients who underwent elective percutaneous intervention for stable Ischaemic Heart Disease during 2014–2018. Primary outcome including death, MI, stent thrombosis need repeat revascularisation within 12 months index procedure. Results treated 909 with mean age 67.5 years 78.4% were males. proportion cohort that met troponin-based based trial, SCAI 4th UDMI 10.1%, 6.3% 25.1%. Occurrence not predictive at 1 year (8.1% v 8.7% p=0.8; 11.1% 8.5% p=0.5; 10.2% 8.1%, p=0.3) (Table 1). one-year rate entire 8.5%. rates steady troponin I levels below 2000 ng/L after which there significant increase 13.2% >2500, 19.1% >5000 33.3% troponin>10,000 ng/L. Conclusions Procedural Trial year, whereas elevations above associated higher cohort. These findings have implications interpretation Trial. potential level stand-alone clinically relevant criteria may explored. Funding Acknowledgement Type funding sources: None.