Angiographic predictors of adverse outcomes in the modern interventional era.

The development of preprocedural angiographic risk stratification criteria was meaningful in the balloon angioplasty era (1). Acute ischemic complications consisted of angiographic complications with impairment of epicardial coronary blood flow. The demonstration that these postpercutaneous coronary intervention (PCI) ischemic complications were related to the preprocedural angiographic complexity of the lesion allowed operators to riskstratify patients. Current practice strategies have made non-angiographic complications, reflected by rise in creatine kinase MB fraction (CK-MB) enzyme, the most common post-PCI adverse event. The clinical impact of these rises in cardiac enzyme after PCI has been debated, but current evidence supports their negative prognostic value, particularly for larger increases in CK-MB (2).