Division of Medicine, The Hatter Cardiovascular Institute, University College Medical School, 67 Chenies Mews, London, UK.
Eur Heart J. 2011 Jan;32(1):23-31. doi: 10.1093/eurheartj/ehq393. Epub 2010 Oct 29.
Percutaneous coronary intervention (PCI) has become the predominant procedure for coronary revascularization in patients with both stable and unstable coronary artery disease (CAD). Over the past two decades, technical advances in PCI have resulted in a better and safer therapeutic procedure with minimal procedural complications. However, about 30% of patients undergoing elective PCI sustain myocardial injury arising from the procedure itself, the extent of which is significant enough to carry prognostic importance. The peri-procedural injury which accompanies PCI might therefore reduce some of the beneficial effects of coronary revascularization. The availability of more sensitive serum biomarkers of myocardial injury such as creatine phosphokinase MB isoenzyme (CK-MB), Troponin T, and Troponin I has enabled the quantification of previously undetectable myocardial injury. Peri-procedural myocardial injury (PMI) can also be visualized by cardiac magnetic resonance imaging, a technique which allows the detection and quantification of myocardial necrosis following PCI. The identification of CAD patients at greatest risk of sustaining PMI during PCI would allow targeted treatment with novel therapies capable of limiting the extent of PMI or reducing the number of patients experiencing PMI.
经皮冠状动脉介入治疗（PCI）已成为稳定型和不稳定型冠心病（CAD）患者冠状动脉血运重建的主要手段。在过去的二十年中，PCI 的技术进步带来了更好、更安全的治疗方法，同时减少了手术相关并发症。然而，约 30%接受择期 PCI 的患者会发生源于该手术本身的心肌损伤，其严重程度足以产生预后影响。因此，PCI 伴随的围手术期损伤可能会降低冠状动脉血运重建的一些有益效果。更多敏感的心肌损伤血清生物标志物如肌酸磷酸激酶同工酶（CK-MB）、肌钙蛋白 T 和肌钙蛋白 I 的出现，使以前无法检测到的心肌损伤得以量化。心脏磁共振成像（CMR）也可以显示围手术期心肌损伤（PMI），该技术可以在 PCI 后检测和量化心肌坏死。识别在 PCI 过程中发生 PMI 风险最大的 CAD 患者，可使他们接受新型治疗，限制 PMI 的程度或减少发生 PMI 的患者数量。
