TCT-626 Impact of Periprocedural Myocardial Infarction on In-Hospital and 2-Year Clinical Outcomes in Patients Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents

• Seung-Woon Rha¹, 
• Byoung Geol Choi¹, 
• Sang-Ho Park², 
• A-Ra Cho², 
• Hyeok-Gyu Lee², 
• Won-Yong Shin²,
• Seung Jin Lee², 
• Dong-Kyu Jin², 
• Se Yeon Choi¹, 
• Amro Elnagar¹, 
• Sung Il Im¹, 
• Sun Won Kim¹, 
• Jin Oh Na¹,
• Seong Woo Han¹, 
• Cheol Ung Choi¹, 
• Hong Euy Lim¹, 
• Jin Won Kim¹, 
• Eung Ju Kim¹, 
• Chang Gyu Park¹,
• Hong Seog Seo¹, 
• Dong Joo Oh¹

• ¹ Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea, Republic of
• ² Cardiology Department, Soonchunhyang university cheonan hospital, Cheonan, Korea, Republic of

Background

There are few studies comparing the long-term clinical outcomes of patients (pts) with peri-procedural myocardial infarction (P-MI) with those without P-MI following percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) in real world clinical practice.

Methods

A total of 1119 pts underwent PCI with DESs between 2004 and 2010 were enrolled (control group, n=1006 pts and P-MI group, n=113 pts). P-MI was defined as major CK-MB elevation (≥3X the upper limit of normal [ULN]) after PCI.

Results

There were no significant differences between the two groups except P-MI group was more elderly, had more female, longer procedure time, higher number of target vessel and stents. At 6 month routine follow-up angiography, there was no significant difference in mean diameter stenosis %, incidence of binary restenosis and late loss between the two groups. Among the major in-hospital outcomes, cardiac death was higher in P-MI group. At 2-year (follow-up, 89.1%), and the cumulative incidence of total death, cardiac death and total major adverse cardiac events (MACEs) were higher in P-MI group, where as repeat PCI including target lesion revascularization (TLR) and target vessel revascularization (TVR). However, when in-hospital mortality was excluded, the major clinical outcomes were not different between the two groups up to 2 years (table).

Conclusions

P-MI was mainly associated with in-hospital cardiac death following PCI with DES in real world clinical practice. However, P-MI doesn't seem to be an independent predictor for adverse clinical outcomes for long-term period.

Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.