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Cited by 650

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Consideration of a New Definition of Clinically Relevant Myocardial Infarction After Coronary Revascularization

Open access
Moussa, Issam D., Klein, Lloyd W., Shah, Binita, Mehran, Roxana, Mack, Michael J., Brilakis, Emmanouil S., Reilly, John P., Zoghbi, Gilbert, Holper, Elizabeth, Stone, Gregg W.·2013·Journal of the American College of Cardiology

Abstract

Numerous definitions have been proposed for the diagnosis of myocardial infarction (MI) after coronary revascularization. The universal definition for MI designates post procedural biomarker thresholds for defining percutaneous coronary intervention (PCI)-related MI (type 4a) and coronary artery bypass grafting (CABG)-related MI (type 5), which are of uncertain prognostic importance. In addition, for both the MI types, cTn is recommended as the biomarker of choice, the prognostic significance of which is less well validated than CK-MB. Widespread adoption of a MI definition not clearly linked to subsequent adverse events such as mortality or heart failure may have serious consequences for the appropriate assessment of devices and therapies, may affect clinical care pathways, and may result in misinterpretation of physician competence. Rather than using an MI definition sensitive for small degrees of myonecrosis (the occurrence of which, based on contemporary large-scale studies, are unlikely to have important clinical consequences), it is instead recommended that a threshold level of biomarker elevation which has been strongly linked to subsequent adverse events in clinical studies be used to define a “clinically relevant MI.” The present document introduces a new definition for “clinically relevant MI” after coronary revascularization (PCI or CABG), which is applicable for use in clinical trials, patient care, and quality outcomes assessment.

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Metadata

Authors
Moussa, I. D., Klein, L. W., Shah, B., Mehran, R., Mack, M. J., Brilakis, E. S., Reilly, J. P., Zoghbi, G., Holper, E., & Stone, G. W.
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2013-10
Volume
62
Issue
17
Pages
1563-1570
ISSN
0735-1097 (ISSN-L)
OpenAlex
W1840021307
Cited by
650
References
2
FWCI
24.15
Type
journal article
Language
en
Open access
bronze

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The paper
Moussa, I. D., Klein, L. W., Shah, B., Mehran, R., Mack, M. J., Brilakis, E. S., Reilly, J. P., Zoghbi, G., Holper, E., & Stone, G. W. (2013). Consideration of a New Definition of Clinically Relevant Myocardial Infarction After Coronary Revascularization. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2013.08.720

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.