Tsabedze Nqoba, McCutcheon Keir, Mkhwanazi Lancelot, Garda Riaz, Vachiat Ahmed, Ramjee Rohan, Moosa Jameel, Maluleke Themba, Mukeshimana Gloria, Karolia Saffiyyah, Mpanya Dineo, Manga Pravin
Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Gauteng, South Africa.
Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Gauteng, South Africa.
Int J Cardiol. 2017 Mar 1;230:175-180. doi: 10.1016/j.ijcard.2016.12.177. Epub 2016 Dec 30.
Percutaneous coronary intervention (PCI) is effective therapy for significant atherosclerotic coronary artery disease. Despite medical and technological advances in PCI, periprocedural myocardial infarction (PMI) remains a common complication. The frequency and factors associated with PMI have been well investigated in the developed world, yet there is a paucity of data from the developing world, especially Sub-Saharan Africa.
We prospectively enrolled 153 adult patients undergoing PCI at the Charlotte Maxeke Johannesburg Academic Hospital from the 1st of February 2014 to 31st October 2014. Periprocedural Creatinine Kinase-MB and hs-Troponin I were routinely measured before PCI and at 16-24h post-procedure. The third universal definition of myocardial infarction was used to define a PMI event.
152 participants met the inclusion criteria and were analysed for PMI. 70.4% participants were male. The mean age was 58.8 (SD 10.9) years old. Sixteen (10.5%) participants fulfilled the criteria for PMI. Side branch pinching with preserved TIMI III flow was noted in 62.5% of PMI cases. Duration of procedure (P=0.007), right coronary artery intervention (p=0.042) and total stent length (p=0.045) were independently associated with PMI.
PMI occurred in 10.5% of cases undergoing PCI. This is consistent with the prevalence of PMI internationally. Larger multicentre studies are required in our demographic region to further define relevant predictors and outcomes associated with PMI.
经皮冠状动脉介入治疗（PCI）是治疗严重动脉粥样硬化性冠状动脉疾病的有效方法。尽管PCI在医学和技术方面取得了进展，但围手术期心肌梗死（PMI）仍然是一种常见的并发症。在发达国家，与PMI相关的发生率和因素已得到充分研究，但发展中国家，尤其是撒哈拉以南非洲的数据却很少。
我们前瞻性地纳入了2014年2月1日至2014年10月31日在夏洛特·马克西克·约翰内斯堡学术医院接受PCI的153例成年患者。在PCI前和术后16 - 24小时常规测量围手术期肌酸激酶-MB和高敏肌钙蛋白I。采用心肌梗死的第三个通用定义来定义PMI事件。
152名参与者符合纳入标准并进行了PMI分析。70.4%的参与者为男性。平均年龄为58.8（标准差10.9）岁。16名（10.5%）参与者符合PMI标准。62.5%的PMI病例中观察到侧支受压但TIMI血流Ⅲ级保留。手术时间（P = 0.007）、右冠状动脉介入治疗（P = 0.042）和总支架长度（P = 0.045）与PMI独立相关。
PMI发生在10.5%的PCI病例中。这与国际上PMI的患病率一致。在我们这个人口统计学区域需要开展更大规模的多中心研究，以进一步确定与PMI相关的相关预测因素和结果。
