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In the current era, periprocedural myocardial infarction (MI) can still occur in a significant proportion of percutaneous coronary interventions (PCIs).1 Large periprocedural ischaemic events are associated with harm; however, even small increases in cardiac enzymes have been associated with increased long-term mortality.2 Attempts to enhance the safety of PCI have typically occurred through the use of potent antiplatelet agents (eg, aspirin, ADP receptor blockers (clopidogrel and prasugrel) and glycoprotein inhibitors (abciximab and eptifibatide)), as well as antithrombin agents (eg, unfractionated heparin, low-molecular weight heparin and bivalirudin). Although antiplatelet and antithrombin agents are effective at reducing ischaemic events, a cost from their use is sometimes paid in terms of major …
Competing interests Novartis Pharmaceuticals, American College of Cardiology Cardiosource