Non-fatal MI as surrogate end point for all-cause or cardiovascular mortality

Article Cardiac & Cardiovascular Systems

Cardiac procedural myocardial injury, infarction, and mortality in patients undergoing elective percutaneous coronary intervention: a pooled analysis of patient-level data

Johanne Silvain et al.

Summary: The prognostic importance of cardiac procedural myocardial injury and myocardial infarction (MI) in chronic coronary syndrome (CCS) patients undergoing elective percutaneous coronary intervention (PCI) is still debated. Post-PCI cTn elevation of >= 5 x 99th percentile URL used to define Type 4a MI is associated with increased 1-year mortality in CCS patients with normal baseline cTn levels.

EUROPEAN HEART JOURNAL (2021)

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Article Medicine, General & Internal

Assessment of Nonfatal Myocardial Infarction as a Surrogate for All-Cause and Cardiovascular Mortality in Treatment or Prevention of Coronary Artery Disease A Meta-analysis of Randomized Clinical Trials

Kevin O'Fee et al.

Summary: This meta-analysis found that nonfatal MI is not a surrogate for all-cause or cardiovascular mortality in randomized clinical trials of interventions to treat or prevent coronary artery disease.

JAMA INTERNAL MEDICINE (2021)

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Article Cardiac & Cardiovascular Systems

Prognostically relevant periprocedural myocardial injury and infarction associated with percutaneous coronary interventions: a Consensus Document of the ESCWorking Group on Cellular Biology of the Heart and European Association of Percutaneous Cardiovascular Interventions (EAPCI)

Heerajnarain Bulluck et al.

Summary: The article recommends measuring baseline and post-PCI cTn values in all CCS patients undergoing PCI and confirms the prognostic relevance of post-PCI cTn elevation >5x 99th percentile URL for defining type 4a MI. In the absence of related complications, the same cTn cut-off threshold can be used to define major periprocedural myocardial injury, which are strong predictors of all-cause mortality post-PCI and can be used as quality metrics in clinical trials. Further research is needed to evaluate treatment strategies for reducing the risk of major periprocedural myocardial injury, type 4a MI, and MACE in CCS patients undergoing PCI.

EUROPEAN HEART JOURNAL (2021)

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Review Medicine, General & Internal