The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Editorials

How should procedure-related myocardial infarction be defined, and does it matter? (Spoiler alert – it does!)

EuroIntervention 2020;15:1393-1396. DOI: 10.4244/EIJV15I16A253

1. The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 2. Cardiovascular Research Foundation, New York, NY, USA


Determining the definition of myocardial infarction (MI) utilised in a clinical trial is a “make or break” decision which may determine whether the study is positive or negative. For example, in both the recent EXCEL trial of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in patients with left main coronary disease and the ISCHEMIA trial of an invasive versus a conservative approach in patients with stable ischaemic heart disease and at least moderate ischaemia, the long-term outcomes for the primary composite endpoint demonstrated non-proportional hazards. In both studies the group that had worse periprocedural ...

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