FREQUENCY AND CAUSES OF PERIPROCEDURAL MYOCARDIAL INFARCTION IN COMPLEX CORONARY INTERVENTIONS

Abstract

Objective: To examine the frequency and cause sof periprocedural myocardialinfarction (PMI) in complex coronary interventions. Methodology: This cross sectional study was conducted at catheterizationlaboratory of Gulab Devi Chest Hospital, Lahore in 6 months duration from June2016 to January 2017. Patients aged between 30 to 80 years undergoingcomplex coronary interventions were included. Blood samples for creatinekinase-MB evaluation were drawn at three different times i.e. Once beforeprocedure, 8-10 and 24 hours after the procedure. CKMB level >3× ULN wasconsidered as PMI. Association of different factors with PMI was also observed. Results: A total of 72 consecutive patients were included in the study.Mean ageof patients was 53.65+11.84 years. There were 56(77.78%) males. PMI wasdetected in 14 (19.44%)patients, with 3–5× ULN in 13.88% and >5× ULN in5.55% of patients. Statistics of study showed that revascularization of left mainstem lesion (1.38 % vs 0 %, p=0.04), in-stent restenosis (2.77 % vs 1.38 %,p=0.03) and procedural complications such as side branch occlusion(1.38%vs0%, p=0.04) and slow/no reflow (4.16 % vs 1.38 %, p=0.004)weresignificantly associated with CKMB elevation following complex coronaryintervention. Conclusion: PMI is common in patients undergoing complex coronaryinterventions. Key Words: Complex coronary intervention, Creatine kinase MB, No reflow,Periprocedural myocardial infarction.