Prognostic Implications of Evolving Universal Definitions of Periprocedural Myocardial Infarction in Patients With Acute Coronary Syndrome
Authors' conclusion
PCI-MI defined according to the fourth UDMI was associated with increased risks of 1-year mortality only in patients with non-ST-segment-elevation ACS.
Study context
- Population
- Patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) in the MATRIX trial
- Participants
- 6,724 patients
- Comparison
- Prognostic implications of second, third and fourth universal definition of MI (UDMI) definitions of PCI-MI
- Primary endpoint
- All-cause and CV death (co-primary) in non-ST-segment-elevation ACS
- Follow-up
- From 24 hours to 1 year after PCI
Methodological detailsPCI-MI prospectively adjudicated
- PCI-MI prospectively adjudicated
Primary result
As reported in the abstract
1 year
Fourth UDMIHazard ratio (95% CI)P value
All-cause death
2.08(1.00–4.30)
P = 0.048CV death
2.62(1.03–6.65)
P = 0.043Secondary outcomes
PCI-MI incidence, overall ACS population
PCI-MI incidence, non-ST-segment-elevation ACS
PCI-MI in STEMI (subgroup)
- PCI-MI uncommon, depending on definition
- 1% to 4%
- Not associated with increased mortality
Isolated troponin elevation up to 20 times the upper reference limit, without ECG or angiographic complications
- Not associated with increased mortality risk
Original publication
Prognostic Implications of Evolving Universal Definitions of Periprocedural Myocardial Infarction in Patients With Acute Coronary Syndrome. Circulation. Published 6 January 2026. doi:10.
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