{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:24:26Z","timestamp":1791944666906,"version":"4.3.4"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T00:00:00Z","timestamp":1687132800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Limited data are available on the risk of periprocedural myocardial infarction (MI) in patients undergoing complex versus noncomplex percutaneous coronary intervention (PCI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We assessed the risk of periprocedural MI according to the fourth Universal definition of myocardial infarction (UDMI) and several other criteria among patients undergoing elective PCI in a prospective, single\u2010center registry. Complex PCI included at least one of the following: 3 coronary vessels treated, \u22653 stents implanted, \u22653 lesions treated, bifurcation with 2 stents implanted, total stent length &gt;60\u2009mm, treatment of chronic total occlusion, and use of rotational atherectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between 2017 and 2021, we included 1010 patients with chronic coronary syndrome, of whom 226 underwent complex PCI (22.4%). The rate of periprocedural MI according to the fourth UDMI was significantly higher in complex compared to noncomplex PCI patients (26.5% vs. 14.5%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Additionally, periprocedural MI was higher in the complex PCI group using SCAI (4% vs. 1.1%, <jats:italic>p<\/jats:italic>\u2009=\u20090.009), ARC\u20102 (13.7% vs. 8.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.013), ISCHEMIA (5.8% vs. 1.7%, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), and EXCEL criteria (4.9% vs. 2.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.032). SYNTAX periprocedural MI occurred at low rates in both groups (0.9% vs. 0.6%, <jats:italic>p<\/jats:italic>\u2009=\u20090.657). Complex PCI was an independent predictor of the fourth UDMI periprocedural MI (odds ratio [OR] 1.54, 95% confidence interval [CI]: 1.04\u20132.27, <jats:italic>p<\/jats:italic>\u2009=\u20090.031).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with chronic coronary syndrome undergoing elective PCI, complex PCI is associated with a significantly higher risk of periprocedural MI using multiple definitions. These findings highlight the importance of considering upfront this risk in the planning of complex PCI procedures.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30749","type":"journal-article","created":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T05:55:28Z","timestamp":1687240528000},"page":"212-220","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Periprocedural myocardial infarction in patients undergoing complex versus noncomplex percutaneous coronary intervention"],"prefix":"10.1002","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3124-9912","authenticated-orcid":false,"given":"Raffaele","family":"Piccolo","sequence":"first","affiliation":[{"name":"Department of Advanced Biomedical Sciences University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1164-0284","authenticated-orcid":false,"given":"Attilio","family":"Leone","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiorenzo","family":"Simonetti","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa","family":"Avvedimento","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7941-0779","authenticated-orcid":false,"given":"Domenico","family":"Angellotti","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Manzi","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Verde","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Anna Maria","family":"Spaccarotella","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6324-8527","authenticated-orcid":false,"given":"Luigi","family":"Di Serafino","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Plinio","family":"Cirillo","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Gargiulo","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences University of Naples Federico II Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuliana","family":"Fortunato","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Medical Biotechnology University of Naples Federico II and CEINGE S.C.a r.l. 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