(Circulation. 2001;104:627.)
© 2001 American Heart Association, Inc.
Editorial |
Troponisms, Necrosettes, Enzyme Leaks, Creatinine Phosphokinase Bumps, and Infarctlets
What’s Behind This New Lexicon and What Does It Add?
Key Words: Editorials • stents • angioplasty • catheters • myocardial infarction
Dramatic improvements in angioplasty technology have allowed initial patient and lesion selection criteria to expand and to include the treatment of complex lesions in critically ill patients. Most recent estimates indicate that 900 000 patients were treated with a percutaneous approach in the United States in 2000 and 1.7 million patients were treated with one worldwide. As the technology has become more complex with the introduction of a variety of stents, atherectomy devices, capture devices, and filters, among others, interventionists have learned more about the procedures and the patients undergoing them.
See p 642
In the early years of balloon angioplasty, success rates were low. In the initial National Heart, Lung and Blood Percutaneous Transluminal Coronary Angioplasty Registry from 1977 and 1981, clinical success, which was defined as a reduction in luminal diameter stenosis by 
20% and no death, infarction, or coronary bypass surgery, was achieved in 61% of patients.1,2 Failures were often the result of dissection or refractory acute closure, emergency coronary bypass graft surgery (often required), and Q-wave myocardial infarction (often resulted). Nonfatal Q-wave myocardial infarction occurred in 4.9% of patients and death, nonfatal Q-wave myocardial infarction, or emergency surgery occurred in 8.8%.1–3 There was often nothing subtle about an angioplasty complication at that time. As operator experience has improved and improvements in technology have become available, these morbid complications have decreased markedly. The need for emergency surgery has declined from 5.8% (initial registry) to 
0.5% (today).
Satisfaction from these advances has been tempered by the recognition of
This article has been cited by other articles:
 |
|
 |
|
  R. Shah, J. Selter, Y. Wang, M. Greenspan, and J. M. Foody Association of Troponin Status With Guideline-Based Management of Acute Myocardial Infarction in Older Persons Arch Intern Med, August 13, 2007; 167(15): 1621 - 1628. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Maynard, E. Lowy, J. Rumsfeld, A. E. Sales, H. Sun, B. Kopjar, B. Fleming, R. L. Jesse, R. Rusch, and S. D. Fihn The prevalence and outcomes of in-hospital acute myocardial infarction in the department of veterans affairs health system. Arch Intern Med, July 10, 2006; 166(13): 1410 - 1416. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. E. Cutlip and R. E. Kuntz Cardiac Enzyme Elevation After Successful Percutaneous Coronary Intervention Is Not an Independent Predictor of Adverse Outcomes Circulation, August 9, 2005; 112(6): 916 - 923. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Jeremias, D. S. Baim, K. K.L. Ho, M. Chauhan, J. P. Carrozza Jr, D. J. Cohen, J. J. Popma, R. E. Kuntz, and D. E. Cutlip Differential mortality risk of postprocedural creatine kinase-MB elevation following successful versus unsuccessful stent procedures J. Am. Coll. Cardiol., September 15, 2004; 44(6): 1210 - 1214. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.T. Roe, K.W. Mahaffey, R. Kilaru, J.H. Alexander, K.M. Akkerhuis, M.L. Simoons, R.A. Harrington, B.E. Tardiff, C.B. Granger, E.M. Ohman, et al. Creatine kinase-MB elevation after percutaneous coronary intervention predicts adverse outcomes in patients with acute coronary syndromes Eur. Heart J., February 2, 2004; 25(4): 313 - 321. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. K. Nallamothu and E. R. Bates Periprocedural myocardial infarction and mortality: Causality versus association J. Am. Coll. Cardiol., October 15, 2003; 42(8): 1412 - 1414. [Full Text] [PDF]
|
|
|
|
|
|
J. R. Kizer, M. R. Muttrej, W. H. Matthai, J. McConnell, H. Nardone, A. F. Sonel, M. G. Keane, and R. L. Wilensky Role of cardiac troponin T in the long-term risk stratification of patients undergoing percutaneous coronary intervention Eur. Heart J., July 2, 2003; 24(14): 1314 - 1322. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. J. Cantor, L. K. Newby, R. H. Christenson, R. H. Tuttle, V. Hasselblad, P. W. Armstrong, D. J. Moliterno, R. M. Califf, E. J. Topol, E. M. Ohman, et al. Prognostic significance of elevated troponin i after percutaneous coronary intervention J. Am. Coll. Cardiol., June 5, 2002; 39(11): 1738 - 1744. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Colombo and G. Stankovic Nothing is lower than 0, and 3 is closer to 0 than to 5--medicine is not arithmetic Eur. Heart J., June 1, 2002; 23(11): 840 - 842. [Full Text] [PDF]
|
|
|
|
 |
|
 Type of MI After PCI Affects Survival Journal Watch Cardiology, October 26, 2001; 2001(1026): 11 - 11. [Full Text]
|
|