Determinants and prognostic implication of periprocedural myocardial injury after successful recanalization of coronary
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ORIGINAL ARTICLE
Determinants and prognostic implication of periprocedural myocardial injury after successful recanalization of coronary chronic total occlusion Luís Graça‑Santos1 · Joana Delgado‑Silva2,3 · Francisco Soares1 · Luís Paiva2,3 · Marco Costa2 · Cristina Neves2 · Elisabete Jorge2 · Lino Gonçalves2,3 Received: 26 January 2020 / Accepted: 20 October 2020 © Japanese Association of Cardiovascular Intervention and Therapeutics 2020
Abstract Periprocedural myocardial injury (PMI) has been generally associated with major adverse cardiac events (MACE), however, limited studies addressed its clinical implications following chronic total occlusion (CTO) percutaneous coronary intervention (PCI). To evaluate the determinants and prognostic implication of PMI following CTO-PCI. Retrospective single-centre study of 125 consecutive patients undergoing CTO-PCI was attempted between December 2013 and December 2017. Angiographic success was achieved in 115 patients (92.0%) and cTn-I values were obtained 12–24 h following PCI. PMI was defined as an elevation of cTn-I above 5 times the 99th-percentile upper reference limit. Baseline demographic, clinical, angiographic and procedural characteristics were compared. Multivariate analysis was performed to determine the predictors of PMI and the correlates of PMI and 1-year MACE, a composite of all-cause death, non-fatal myocardial infarction, and target lesion revascularization. Overall, mean age was 67 ± 17 years; 25 patients (21.7%) were female; and PMI occurred in 41 patients (35.7%). Multivessel coronary artery disease (MVD) (odds ratio [OR], 3.41; 95% confidence interval [CI], 1.09–10.67; p = 0.04) and procedural complications (a composite of iatrogenic coronary artery dissection/ haematoma or perforation) (OR, 19.08; 95% CI, 3.77–96.65; p
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