POST PCI MYOCARDIAL INFARCTION A SILENT KILLER FACT OR FICTION. DOES IT REALLY EXIST? WHERE DO WE STAND?

Objective: To determine the frequency of peri-pocedural myocardial infarction in patients with stable coronary artery disease undergoing elective percutaneous coronary angioplasty. Methodology: This was a descriptive study conducted in the cardiac cath lab of the National Institute of Cardiovascular Diseases Karachi, Pakistan. Patients with stable obstructive coronary artery disease undergoing elective coronary angioplasty were included in this study. PMI was defined as a rise in troponin I above five times the upper limit of the normal range (the third universal definition of MI). Collected data were entered and analyzed using SPSS 19. Results: Among the total of 107 patients male predominance, 82.2% (88), was observed and mean ± SD age of the patients was 52.02 ± 9.10 years with a majority, 92(86.0%), of patients between 41 to 80 years of age. Peri-procedural myocardial infarction (PMI) was found in 16(15.0%) of the patients and PMI was observed to be independent of baseline risk profile and angiographic characteristics of the patients. While, based on criteria of troponin I above three times the upper limit of the normal range, PMI was observed in 22(20.6%) of the patients. Conclusion: High incidence of the post-procedural rise of troponin in our study population is alarming. Further studies are required to identify the cause and hence identifying measures to prevent PMI. Universal single definition is required worldwide in order to get uniform results. Keywords: Post PCI Myocardial Infarction, Coronary angioplasty, Third universal definition