Towards an improved definition of periprocedural myocardial infarction: The role of high‐sensitivity cardiac troponins

Abstract

In the past few years, many have disputed the optimal biomarker for confirming or ruling out a diagnosis of periprocedural myocardial infarction (PMI) and the optimal cut‐off concentrations to apply. In this issue of the Journal of Cardiac Surgery, Niclauss et al. performed a retrospective analysis of CK‐MB and high‐sensitivity cardiac troponin T (hs‐cTnT) dynamics and peak concentrations following different cardiac surgical interventions in 400 patients during a 2‐year period in a single center. The authors found that CK‐MB and hs‐cTnT predict PMI with a comparable diagnostic accuracy and discriminatory power >95%. They also attempted to propose an improved, more sensitive threshold of hs‐cTnT for PMI. Their findings could have implications for clinical practice, but more research is warranted to identify more appropriate cut‐offs. This could include hs‐cTnT release pattern, slope steepness, and changes. Ultimately, this could results in patient‐specific model, able to predict expected and abnormal ranges of hs‐cTnT release, enabling an improved and timely diagnosis of PMI.

Pregnancy related acute myocardial infarction: Current trends in treatment and future prospects

“…The acute myocardial infarction is characterized by the sudden obstruction of a coronary artery caused by the rapid creation of a thrombus on an atherosclerotic plaque and is triggered by the random rupture of its capsule. The abolition of coronary circulation and the consequent lack of oxygen supply to the corresponding part of the myocardium cause scar-forming necrosis, which then cause a disturbance to the functional ability of the heart, simply maintaining the anatomical integrity of the left ventricle [2] .…”