Naeem Asghar, Muhammad Nazim, Shakeel Ahmad.
POST-PCI clinical outcome; co-relation with cardiac biochemical markers.
Professional Med J Jan ;24(2):228-33.

Introduction: The incidence of creatine kinase-myocardial band (CK-MB) isoenzyme elevation after percutaneous coronary intervention (PCI) ranges from 11% to 35%, including low-level elevations with no associated signs or symptoms as well as large non–Qwave and Q-wave myocardial infarction. Whereas the deleterious effect on survival of large periprocedural myocardial infarctions have been well documented. Large periprocedural myocardial infarctions, such as those caused by occlusion of a large side branch, flow-limiting dissection, or distal embolization of a large thrombus, would be undesirable and associated with worse subsequent cardiac outcomes. Objectives: To correlate the clinical outcome after PCI with cardiac biochemical markers. Study Design: Observational follow-up study. Setting: Faisalabad Institute of Cardiology, Faisalabad. Duration of Study with Dates: Six months (February, 2014 to August, 2014). Patients and Methods: Two hundred patients with symptoms of myocardial ischemia proceeding for percutaneous coronary intervention were enrolled in the study. After taking history and clinical examination, the patients divided into two groups: group I and group II. Group I comprised one hundred and fifty patients having normal cardiac enzymes and group II comprised fifty patients having raised cardiac enzymes. Results: Out of 50 patients with raised cardiac enzymes 42 (84%) were males and 8 (16%) were females, multi vessel coronary disease (58%), multi vessel PCI (54.3%). Periprocedural complications dissection (6%), side branch compromise (14%), slow flow (10%), no reflow (2%), sub-acute stent thrombosis (4%) occurred in group II as compared to slow flow (1.4%) and sub-acute stent thrombosis (0.7%) in group I. In hospital mortality (2%) in group II while no mortality in group I. On thirty day follow up 32% patients became symptomatic among which 6% developed non ST elevation MI in group II while only 1.4% patients had symptoms of angina in group I. 6% patients needed repeat target lesion revascularization in group II and only 0.7% in group I. Conclusion: Patients with raised cardiac enzymes had worse clinical outcome in terms of mortality, myocardial infarction and repeat target lesion revascularization than normal cardiac enzymes.

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