Association between the magnitude of periprocedural myocardial injury and prognosis in patients undergoing elective percutaneous coronary intervention

Figure 1. Flowchart of the study.

Figure 2. Distribution of post-percutaneous coronary intervention troponins. Distribution of post-percutaneous coronary intervention high-sensitivity cardiac troponin T in all patients. Horizontal lines indicate the incidence of periprocedural myocardial injury according to the cut-off thresholds of high-sensitivity cardiac troponin levels. hs-cTnT, high-sensitivity cardiac troponin T; PCI, percutaneous coronary intervention; PMI, periprocedural myocardial injury; and URL, upper reference limit.

Figure 3. Adjusted hazard ratios of clinical endpoints According to periprocedural myocardial injury, *a significant P < 0.05. Different thresholds of post-percutaneous coronary intervention high-sensitivity cardiac troponin are used to define periprocedural myocardial injury. Adjusted hazard ratios of major adverse cardiovascular events, all-cause death, myocardial infarction, ischaemic stroke, and unplanned revascularization according to cut-off values of periprocedural myocardial injury are shown in columns. The variables included in the multivariate model were as follows: age (per 5 years increase), sex, hypertension, diabetes, smoking history, old myocardial infarction, prior percutaneous coronary intervention, eGFR <60 mL/min/1.73 m2, number of target vessels, stent length (per 10 mm increase), and procedural complications (side-branch loss, dissection, and slow flow/no reflow). MACEs, major adverse cardiovascular events; MI, myocardial infarction; PCI, percutaneous coronary intervention; PMI, periprocedural myocardial injury; and URL, upper reference limit.

Figure 4. Time-to-event curves for clinical endpoints. (A) The cumulative incidence of all-cause death in patients with post-percutaneous coronary intervention high-sensitivity cardiac troponin >8× upper reference limit and those without. (B) The cumulative incidence of myocardial infarction. (C) The cumulative incidence of ischaemic stroke, and (D) the cumulative incidence of unplanned revascularization. In each panel, the inset shows the same data on an enlarged y-axis. MI, myocardial infarction; PCI, percutaneous coronary intervention; and URL, upper reference limit.

Figure 5. Subgroup analysis for major adverse cardiovascular events. Data are n/n assessed (%). The adjusted hazard ratio for major adverse cardiovascular events was calculated in patients who had a post-percutaneous coronary intervention high-sensitivity cardiac troponin >8× URL compared with patients who did not. CI, confidence interval; HR, hazard ratio; PCI, percutaneous coronary intervention; PMI, periprocedural myocardial injury; OMI, old myocardial infarction.