Armillotta Matteo, Angeli Francesco, Rinaldi Andrea, Bertolini Davide, Amicone Sara, Bodega Francesca, Fedele Damiano, Impellizzeri Andrea, Di Iuorio Ornella, Bergamaschi Luca, Paolisso Pasquale, Foà Alberto, Stefanizzi Andrea, Sansonetti Angelo, Canton Lisa, Suma Nicole, Tattilo Francesco Pio, Cavallo Daniele, Ryabenko Khrystyna, Casuso Alvarez Marcello, Tortorici Gianfranco, Pizzi Carmine
U.O. Cardiologia, IRCCS Azienda Ospedaliero-Universitaria di Bologna.
U.O. Cardiologia, IRCCS Azienda Ospedaliero-Universitaria di Bologna - Dipartimento di Scienze Mediche e Chirurgiche - DIMEC, Alma Mater Studiorum, Università degli Studi, Bologna.
G Ital Cardiol (Rome). 2023 Nov;24(11):880-892. doi: 10.1714/4129.41231.
Myocardial revascularization, either percutaneous or surgical, is the cornerstone of chronic and acute ischemic coronary artery disease therapy. Periprocedural myocardial injury and infarction are possible complications of these procedures. Several pathogenetic mechanisms have been proposed in the setting of percutaneous (distal embolism, vasospasm, obstruction of a minor vessel) or surgical revascularization (prolonged ischemic time, early graft failure, arrhythmia or severe hypotension during the procedure). High-sensitivity cardiac troponins have emerged as the recommended biomarkers due to their important prognostic implications. However, data regarding diagnostic criteria, management and prognostic implications of these complications are lacking. The present review aims to provide an overview regarding the possible diagnostic criteria, management and prognostic role of periprocedural myocardial injury and infarction.
心肌血运重建，无论是经皮的还是外科手术的，都是慢性和急性缺血性冠状动脉疾病治疗的基石。围手术期心肌损伤和梗死是这些手术可能的并发症。在经皮（远端栓塞、血管痉挛、小血管阻塞）或外科血运重建（缺血时间延长、早期移植物功能衰竭、手术期间心律失常或严重低血压）的情况下，已经提出了几种发病机制。由于其重要的预后意义，高敏心肌肌钙蛋白已成为推荐的生物标志物。然而，关于这些并发症的诊断标准、管理和预后意义的数据尚缺乏。本综述旨在概述围手术期心肌损伤和梗死可能的诊断标准、管理及预后作用。
