Risk factors for periprocedural myocardial injury
|Risk factors for periprocedural myocardial injury
Risk factors for periprocedural myocardial injury can be classified into patient related factors, lesion related factors and procedure related factors [1].
Patient related factors include:
- The extent of coronary artery disease (multivessel disease increases risk 1.3 to 1.8 fold)
- Presence of systemic atherosclerosis
- Older age
- Comorbidities like renal failure
- Unstable angina
- Pre procedural CRP elevation
The lesion related factors predicting periprocedural myocardial injury are:
- Restenotic lesions
- Saphenous vein graft disease
- Eccentric lesions
- Greater plaque burden
- Higher thrombus burden
- Plaque rupture
- Presence of major side branches
Procedure related factors were:
- Threatened or acute vascular closure
- Distal embolisation
- No reflow or slow reflow
- Need for directional coronary atherectomy
In general, more complex procedure would have higher incidence of periprocedural myocardial injury.
Reference
- Joerg Herrmann. Peri-procedural myocardial injury: 2005 update. Eur Heart J. 2005 Dec;26(23):2493-519.