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관상동맥중재술과 연관된 심근경색증의 정의

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Abstract
Background: The criteria for clinically relevant myocardial infarction (MI) associated with percutaneous coronary intervention (PCI) remains debatable. We aimed to determine the criteria of periprocedural MI associated with long-term mortality and with mortality rate similar to spontaneous MI.
Methods: From four prospective PCI registries, 17,190 patients with negative creatine kinase-MB (CK-MB) elevation at baseline who underwent drug-eluting stenting were included. Chest pain, cardiac enzyme, electrocardiographic changes, and angiographic mechanism were prospectively collected and independently adjudicated. Periprocedural MI was defined as post-PCI CK-MB elevation ≥3 times the upper reference limit (URL). Spontaneous MI was defined as spontaneous, non-PCI-related CK-MB elevation. The primary endpoint was all-cause mortality at a median follow-up of 4.5 years (interquartile range: 3.2, 5.2 years).
Results: The criteria of clinically relevant periprocedural MI associated with a higher risk of long-term mortality was CK-MB elevation ≥3 times the URL plus new-onset Q wave or angiographic major vessel complications or CK-MB elevation ≥10 times the URL (incidence, 2.9%; adjusted hazard ratio, 1.61; 95% confidence interval, 1.20-2.14; P=0.001). However, standardized mortality rate of periprocedural MI achieving new criteria was lower than that of spontaneous MI (2.28 per 100 person-year versus 6.14 per 100 person-year). CK-MB threshold for periprocedural MI with mortality similar to spontaneous MI was 58 times the URL.
Conclusions: This study provided criteria for periprocedural MI with a higher risk of long-term mortality based on the combination of cardiac enzyme elevation and supportive clinical features. Nevertheless, clinically relevant periprocedural MI showed lower mortality rate than spontaneous MI.
Author(s)
안정민
Issued Date
2018
Awarded Date
2019-02
Type
Dissertation
URI
https://oak.ulsan.ac.kr/handle/2021.oak/6531
http://ulsan.dcollection.net/common/orgView/200000178639
Alternative Author(s)
Jung-Min Ahn
Affiliation
울산대학교
Department
일반대학원 의학과
Advisor
김영학
Degree
Doctor
Publisher
울산대학교 일반대학원 의학과
Language
eng
Rights
울산대학교 논문은 저작권에 의해 보호받습니다.
Appears in Collections:
Medicine > 2. Theses (Ph.D)
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