Procedural MI Definition Makes a Big Difference in PCI vs CABG Showdown

Certain procedural heart attacks were more clinically significant than others after percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) surgery, reports suggested.

Just how clinically relevant procedural myocardial infarctions (MIs) are after PCI has long been a point of controversy, especially when comparing the procedure to CABG, where some degree of myocardial injury is inherently expected.

Just how sensitive the results of the EXCEL and SYNTAX trials were to how peri-procedural MI had been defined was detailed in two post hoc analyses published in the Oct. 6 issue of the Journal of the American College of Cardiology.

EXCEL vs Third Universal Definition

EXCEL investigators defended their pre-specified protocol definition of peri-procedural MI and the conclusions they drew from the trial despite conflicting findings when such heart attacks were counted according to the Third Universal Definition.

The incidence of procedural MI reached 3.6% of the PCI group and

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