{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T22:26:32Z","timestamp":1790375192899,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T00:00:00Z","timestamp":1606694400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["CS\/14\/3\/31002"],"award-info":[{"award-number":["CS\/14\/3\/31002"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute for Health Research University College London Hospitals Biomedical Research Centre"},{"name":"Duke-National University Singapore Medical School"},{"name":"Singapore Ministry of Health\u2019s National Medical Research Council"},{"name":"Clinician Scientist-Senior Investigator","award":["NMRC\/CSA-SI\/0011\/2017"],"award-info":[{"award-number":["NMRC\/CSA-SI\/0011\/2017"]}]},{"name":"Collaborative Centre Grant scheme","award":["NMRC\/CGAug16C006"],"award-info":[{"award-number":["NMRC\/CGAug16C006"]}]},{"name":"Collaborative Centre Grant scheme","award":["EU-CARDIOPROTECTION CA16225"],"award-info":[{"award-number":["EU-CARDIOPROTECTION CA16225"]}]},{"DOI":"10.13039\/501100000921","name":"COST","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000921","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000921","name":"European Cooperation in Science and Technology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000921","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Cardiology Department, Munich University Centre, Ludwig-Maximilians University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The prognostic importance of cardiac procedural myocardial injury and myocardial infarction (MI) in chronic coronary syndrome (CCS) patients undergoing elective percutaneous coronary intervention (PCI) is still debated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We analysed individual data of 9081 patients undergoing elective PCI with normal pre-PCI baseline cardiac troponin (cTn) levels. Multivariate models evaluated the association between post-PCI elevations in cTn and 1-year mortality, while an interval analysis evaluated the impact of the size of the myocardial injury on mortality. Our analysis was performed in the overall population and also according to the type of cTn used [52.0% had high-sensitivity cTn (hs-cTn)]. Procedural myocardial injury, as defined by the Fourth Universal Definition of MI (UDMI) [post-PCI cTn elevation \u22651 \u00d7 99th percentile upper reference limit (URL)], occurred in 52.8% of patients and was not associated with 1-year mortality [adj odds ratio (OR), 1.35, 95% confidence interval (CI) (0.84\u20131.77), P\u2009=\u20090.21]. The association between post-PCI cTn elevation and 1-year mortality was significant starting \u22653 \u00d7 99th percentile URL. Major myocardial injury defined by post-PCI \u22655 \u00d7 99th percentile URL occurred in 18.2% of patients and was associated with a two-fold increase in the adjusted odds of 1-year mortality [2.29, 95% CI (1.32\u20133.97), P\u2009=\u20090.004]. In the subset of patients for whom periprocedural evidence of ischaemia was collected (n\u2009=\u20092316), Type 4a MI defined by the Fourth UDMI occurred in 12.7% of patients and was strongly associated with 1-year mortality [adj OR 3.21, 95% CI (1.42\u20137.27), P\u2009=\u20090.005]. We also present our results according to the type of troponin used (hs-cTn or conventional troponin).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our analysis has demonstrated that in CCS patients with normal baseline cTn levels, the post-PCI cTn elevation of \u22655 \u00d7 99th percentile URL used to define Type 4a MI is associated with 1-year mortality and could be used to detect \u2018major\u2019 procedural myocardial injury in the absence of procedural complications or evidence of new myocardial ischaemia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehaa885","type":"journal-article","created":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T15:23:42Z","timestamp":1602689022000},"page":"323-334","source":"Crossref","is-referenced-by-count":119,"title":["Procedural myocardial injury, infarction and mortality in patients undergoing elective PCI: a pooled analysis of patient-level data"],"prefix":"10.1093","volume":"42","author":[{"given":"Johanne","family":"Silvain","sequence":"first","affiliation":[{"name":"Sorbonne Universit\u00e9, ACTION Study Group, Institut de Cardiologie, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re (AP-HP) , INSERM UMRS 1166, 47-83 bld de l\u2019H\u00f4pital, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Zeitouni","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, ACTION Study Group, Institut de Cardiologie, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re (AP-HP) , INSERM UMRS 1166, 47-83 bld de l\u2019H\u00f4pital, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Paradies","sequence":"additional","affiliation":[{"name":"Cardiology Department, Maasstad Hospital , Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3976-0088","authenticated-orcid":false,"given":"Huili L","family":"Zheng","sequence":"additional","affiliation":[{"name":"Health Promotion Board, National Registry of Diseases Office , Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gjin","family":"Ndrepepa","sequence":"additional","affiliation":[{"name":"Department of Adult Cardiology, Deutsches Herzzentrum M\u00fcnchen, Technische Universit\u00e4t , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Cavallini","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Ospedale S Maria della Misericordia , Piazzale Meneghini 1, Perugia 06100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitri N","family":"Feldman","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Weill Cornell Medical College , New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1888-0793","authenticated-orcid":false,"given":"Samin K","family":"Sharma","sequence":"additional","affiliation":[{"name":"Cardiac Catheterization Laboratory, Cardiovascular Institute, Mount Sinai Hospital , New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julinda","family":"Mehilli","sequence":"additional","affiliation":[{"name":"Munich University Clinic, Ludwig-Maximilians University , Munich, Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance , Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0542-0448","authenticated-orcid":false,"given":"Sebastiano","family":"Gili","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino, IRCCS , Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0050-5178","authenticated-orcid":false,"given":"Emanuele","family":"Barbato","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, University of Naples Federico II , Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Tarantini","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School , Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sze Y","family":"Ooi","sequence":"additional","affiliation":[{"name":"Eastern Heart Clinic, Prince of Wales Hospital , Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens","family":"von Birgelen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente , Enschede, Netherlands"},{"name":"Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente , Enschede, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan S","family":"Jaffe","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mayo Clinic , Rochester, MN, USA"},{"name":"Department of Laboratory Medicine and Pathology, Mayo Clinic , Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3674-1308","authenticated-orcid":false,"given":"Kristian","family":"Thygesen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital , Aarhus, 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