September 10, 2012Heart
Peri-procedural myocardial infarction and troponism: a quick journey through the land of confusion
Key result
The adoption of troponin for defining periprocedural myocardial infarction has been consensus-driven rather than evidence-based, highlighting the need to scientifically challenge this practice.
Design
Editorial
Authors
Discussion
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Member takes
Implication
The editorial challenges the consensus-driven adoption of troponin for defining peri-procedural myocardial infarction, arguing it lacks sufficient evidence compared to CK/CK-MB.
Key Points
- To critically examine the validity and clinical evidence behind replacing creatine kinase-MB with high-sensitivity troponin when defining periprocedural myocardial infarction in cardiovascular clinical trials.
- Expert commentary and narrative evaluation of historical clinical trial endpoints and biomarker definitions.
- Comparison of creatine kinase/creatine kinase-MB and cardiac troponin regarding sensitivity, specificity, and prognostic value in spontaneous versus procedure-related myocardial injury.
- The clinical transition from CK-MB to troponin for defining procedural myocardial infarction was guided predominantly by expert consensus rather than robust prospective evidence.
- Troponin offers higher analytical sensitivity for myocardial damage, but elevated levels after coronary procedures lack the established correlation with long-term mortality seen in spontaneous myocardial infarction.
PICO
P
Population
Procedural myocardial infarction
Cite This Study
Valgimigli et al. (2012) conducted an editorial in Procedural myocardial infarction. The adoption of troponin for defining periprocedural myocardial infarction has been consensus-driven rather than evidence-based, highlighting the need to scientifically challenge this practice.