Incidence of periprocedural myocardial infarction and cardiac biomarker testing after percutaneous coronary intervention in Japan: Results from a multicenter registry

Takahide Arai, Shinsuke Yuasa, Hiroaki Miyata, Akio Kawamura, Yuichiro Maekawa, Shiro Ishikawa, Shigetaka Noma, Soushin Inoue, Yuji Sato, Shun Kosaka, Keiichi Fukuda

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Periprocedural myocardial infarction (pMI) is an important complication associated with percutaneous coronary intervention (PCI). However, data on the frequency of biomarker testing and the incidence of pMI remain unclear. Using the multicenter Japan Cardiovascular Database, we identified 2182 patients who underwent PCI without preprocedural cardiac biomarker elevation (silent ischemia, stable angina, or unstable angina without biomarker elevation) from September 2008 to August 2011. Of these, 550 patients (25.2 %) underwent cardiac biomarker testing within 6-24 h after PCI. The incidence of pMI was 2.7 % among all identified patients and 7.5 % among those who underwent cardiac marker testing. Of note, cardiac biomarker testing was performed more frequently than no testing in patients with a higher risk profile such as unstable angina (32.7 vs 24.7 %, P < 0.001), higher symptom scaling (28.2 vs 22.5 %, P = 0.008), urgent or emergent procedures (19.3 vs 15.0 %, P = 0.022 or 4.2 vs 1.0 %, P < 0.001, respectively), and type C lesion (31.3 vs 25.2 %, P = 0.006). Presentation with silent ischemia (odds ratio = 1.51, 95 % confidence interval (CI) 1.16-1.97) and nonemergent PCIs (odds ratio = 3.45, 95 % CI 1.79-6.67) were associated with no postprocedural cardiac biomarker testing. The real-world multicenter PCI registry in Japan revealed an incidence of 2.7 % for pMI; however, cardiac biomarkers were assessed in only 25.2 % of patients after PCI. The results suggest an underuse of postprocedural biomarker testing and room for procedural quality improvement, particularly in cases of silent ischemia and nonemergent cases.

Original languageEnglish
Pages (from-to)714-719
Number of pages6
JournalHeart and Vessels
Volume28
Issue number6
DOIs
Publication statusPublished - 2013 Nov

Fingerprint

Percutaneous Coronary Intervention
Registries
Japan
Biomarkers
Myocardial Infarction
Incidence
Ischemia
Unstable Angina
Odds Ratio
Confidence Intervals
Stable Angina
Quality Improvement
Databases

Keywords

  • Cardiac biomarker testing
  • Percutaneous coronary intervention
  • Periprocedural myocardial infarction
  • Quality metrics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Incidence of periprocedural myocardial infarction and cardiac biomarker testing after percutaneous coronary intervention in Japan : Results from a multicenter registry. / Arai, Takahide; Yuasa, Shinsuke; Miyata, Hiroaki; Kawamura, Akio; Maekawa, Yuichiro; Ishikawa, Shiro; Noma, Shigetaka; Inoue, Soushin; Sato, Yuji; Kosaka, Shun; Fukuda, Keiichi.

In: Heart and Vessels, Vol. 28, No. 6, 11.2013, p. 714-719.

Research output: Contribution to journalArticle

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abstract = "Periprocedural myocardial infarction (pMI) is an important complication associated with percutaneous coronary intervention (PCI). However, data on the frequency of biomarker testing and the incidence of pMI remain unclear. Using the multicenter Japan Cardiovascular Database, we identified 2182 patients who underwent PCI without preprocedural cardiac biomarker elevation (silent ischemia, stable angina, or unstable angina without biomarker elevation) from September 2008 to August 2011. Of these, 550 patients (25.2 {\%}) underwent cardiac biomarker testing within 6-24 h after PCI. The incidence of pMI was 2.7 {\%} among all identified patients and 7.5 {\%} among those who underwent cardiac marker testing. Of note, cardiac biomarker testing was performed more frequently than no testing in patients with a higher risk profile such as unstable angina (32.7 vs 24.7 {\%}, P < 0.001), higher symptom scaling (28.2 vs 22.5 {\%}, P = 0.008), urgent or emergent procedures (19.3 vs 15.0 {\%}, P = 0.022 or 4.2 vs 1.0 {\%}, P < 0.001, respectively), and type C lesion (31.3 vs 25.2 {\%}, P = 0.006). Presentation with silent ischemia (odds ratio = 1.51, 95 {\%} confidence interval (CI) 1.16-1.97) and nonemergent PCIs (odds ratio = 3.45, 95 {\%} CI 1.79-6.67) were associated with no postprocedural cardiac biomarker testing. The real-world multicenter PCI registry in Japan revealed an incidence of 2.7 {\%} for pMI; however, cardiac biomarkers were assessed in only 25.2 {\%} of patients after PCI. The results suggest an underuse of postprocedural biomarker testing and room for procedural quality improvement, particularly in cases of silent ischemia and nonemergent cases.",
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