Is CT the better angiogram? Coronary interventions and CT imaging.

Periprocedural myocardial infarction is a potential problem of percutaneous coronary intervention. Even after seemingly uncomplicated, straightforward elective coronary interventions, elevation of cardiac enzymes can be observed and occur in approximately one-third of cases (1). Such enzyme elevations have been shown to be associated with myocardial injury, for example, by magnetic resonance studies (2,3). Both for troponin elevation (1) and for detectable myocardial scar following elective percutaneous intervention (4), substantial prognostic implications have been demonstrated; in a metaanalysis of more than 15,000 patients, Nienhuis et al. (1) found post-interventional troponin release to be associated with a 35% increase in mortality.