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The Platelet, the Patient, and Periprocedural Infarction During Percutaneous Transluminal Coronary Angioplasty

David L. Fischman, MD; Michael P. Savage, MD
JAMA. 1997;278(6):518-519. doi:10.1001/jama.1997.03550060094043.
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It is estimated that in 1997,1 million percutaneous coronary interventions will be performed worldwide. This dramatic growth in nonsurgical coronary revascularization has primarily occurred because of the development of innovative techniques and catheters, including coronary stents. Despite this growth and the improved success rates for these procedures, acute ischemic complications following balloon angioplasty remain an important problem associated with significant morbidity and mortality.1,2 In addition, postprocedure elevation of cardiac enzymes has been associated with an increased incidence of late adverse cardiac events even when successful revascularization is achieved.3 Kong et al4 recently reported a more than 2-fold increase in late cardiac mortality (mean duration >3.5 years) in patients with a mild elevation (1.5 × upper limit of normal) in the creatine kinase enzyme following balloon angioplasty. In this study, creatine kinase elevation predicted an increased risk of late mortality, which was independent of clinical variables, severity of


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