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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