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Friday, February 21, 2014


MedPage Today (10/15, Neale, 122K) reports that “the Society for Cardiovascular Angiography and Interventions (SCAI) has released a new definition for myocardial infarction (MI) following coronary revascularization” intended to identify “only those events likely to be related to poorer patient outcomes.” In this new definition, which is “published as an expert consensus document in Catheterization and Cardiovascular Interventions and the Journal of the American College of Cardiology...creatine kinase-myocardial band (CK-MB) is the preferred cardiac biomarker over troponin, and much greater elevations are required to define a clinically relevant MI compared with the universal definition of MI proposed in 2007 and revised in 2012.” Additionally, “the new definition uses the same biomarker elevation thresholds to identify MIs following both percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), whereas the universal definition has different thresholds for events following the two procedures.”
CardioSource (10/15, 2K) reports, “An accompanying editorial by Harvey White, DSC, FACC, from the Green Lane Cardiovascular Service, Auckland City Hospital, New Zealand, argues that there may be negative unintended consequences for having different definitions.” White “adds that ‘CK-MB is now unavailable in an increasing number of hospitals. With CK-MB becoming obsolete, troponin will become the gold standard, and CK-MB will no longer have a role in defining PCI injury and infarction in clinical practice.’”
MedScape (10/15, Wood, 164K) reports that lead author Dr Issam Moussa “is quick to emphasize that these new clinically meaningful definitions have limited evidence to support them – and most of what exists supports CK-MB definitions, not cTn – but that the new document is based on the best scientific evidence available.”

POSTED BY:  Steven Almany M.D.

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