scholarly journals Minor Myocardial Injury: An Early Post Intervention Complication

2017 ◽  
Vol 5 (2) ◽  
pp. 94-98
Author(s):  
Syeda Fahmida Afrin ◽  
Md Hasanur Rahman ◽  
Md Asadul Millat ◽  
Md Shafiul Alam Quarashi ◽  
Asma Begum ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Myocardial Injury ◽  
Troponin I ◽  
Myocardial Necrosis ◽  
Coronary Intervention ◽  
Vascular Complication ◽  
Post Intervention ◽  
Cardiac Procedure ◽  
Percutaneous Coronary ◽  
Long Term Prognosis

Percutaneous Coronary Intervention (PCI) is the most commonly performed invasive therapeutic cardiac procedure and plays an important role in the treatment of ischemic heart disease. Complications of Percutaneous Coronary Intervention (PCI) are relatively infrequent. The most common complications include discomfort and bleeding at the puncture site where the catheter was inserted. Major complications include death, MI, or stroke and other infrequent complications include transient ischemic attacks (minor myocardial injury), vascular complication and contrast induced nephropathy, transient ischemia, or minor myocardial injury (MMI), myocardial necrosis due to compromisation of threatened coronary circulation during balloon inflation. Cardiac Troponin I (cTnI) assays for the assessment of myocardial injury has been demonstrated for the diagnosis of MMI and long term prognosis after PCI.Delta Med Col J. Jul 2017 5(2): 94-98

scholarly journals Effects of Trimetazidine Pretreatment on Endothelial Dysfunction and Myocardial Injury in Unstable Angina Patients Undergoing Percutaneous Coronary Intervention

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Shuai Shao ◽  
Zhaozhao Shi ◽  
Gary Tse ◽  
Xinghua Wang ◽  
Yanping Ni ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Endothelial Dysfunction ◽  
Unstable Angina ◽  
Myocardial Injury ◽  
Troponin I ◽  
Perioperative Period ◽  
Coronary Intervention ◽  
Control Group ◽  
Fatty Acid Binding ◽  
Percutaneous Coronary

Objectives. Trimetazidine is an anti-ischemic medication licensed for the treatment of angina pectoris. However, the molecular mechanisms underlying its action remain incompletely elucidated. In this study, therefore, we examined the potential beneficial effects of trimetazidine on myocardial injury and endothelial dysfunction in patients with unstable angina in the perioperative period of percutaneous coronary intervention (PCI). Methods. A total of 97 patients with unstable angina were randomly divided into trimetazidine (n = 48) and control (n = 49) groups. All subjects received standard medical therapy. The trimetazidine group additionally received 20 mg trimetazidine three times daily 24 hours before and after PCI. Serum levels of creatine kinase-muscle/brain (CK-MB), cardiac troponin I (cTnI), heart-type fatty acid-binding protein (h-FABP), von Willebrand factor (vWF), and nitric oxide (NO) were measured before and the morning following PCI. Results. In the control group, levels of CK-MB, cTnI, and vWF were significantly elevated (P<0.05) and NO level was decreased after PCI (P<0.05). By contrast, no significant changes in the levels of these proteins were observed in the trimetazidine group after PCI (P>0.05). Moreover, h-FABP levels were not significantly altered after PCI whether in the control or in the trimetazidine group (P>0.05). Finally, a time-dependent increase in the levels of h-FABP from 0 to 6 hours after PCI, followed by a progressive decline, was observed (P<0.05). Conclusions. PCI induces endothelial dysfunction and myocardial damage in patients with unstable angina. Trimetazidine therapy in the perioperative period can reduce this damage.

scholarly journals Effectiveness of Ranolazine to Prevent Myocardial Injury During Elective Percutaneous Coronary Intervention

2019 ◽  
Vol 10 (1) ◽  
pp. 43-49
Author(s):  
SM Mamun Iqbal ◽  
Syed Ali Ahsan ◽  
Kasekh Akhtar Jahan ◽  
Sohely Nazneen Eva
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Myocardial Injury ◽  
Troponin I ◽  
Chronic Stable Angina ◽  
Coronary Intervention ◽  
Control Group ◽  
Interventional Study ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
Periprocedural Myocardial Injury

Background: Ranolazine is a novel antianginal drug that reduces intracellular accumulation of calcium ion in ischemic myocardium. A pilot randomized study (n=70) has shown that pretreatment with ranolazine 1000mg twice daily for 7days significantly reduced periprocedural myocardial injury (PMI) in elective Percutaneous coronary intervention (PCI). Our objective was to detect whether similar effect could be obtained by ranolazine pretreatment through an interventional study. Materials & Methods: 110 patients with chronic stable angina scheduled for elective PCI were enrolled in an interventional study. For 7 days before the procedure, 55 patients were allocated to receive ranolazine 1000 mg twice daily (ranolazine group) and 55 patients didn't receive ranolazine (control group). Serum creatinine kinase-MB (CK-MB) and Troponin I levels were measured at baseline and 24 hours post procedure. Results: Periprocedural myocardial injury [i.e. an elevation of serum biomarkers (preferably cardiac troponins) above the 99th percentile of upper reference limit (URL)] was detected less commonly after PCI in ranolazine than in control group (11% vs. 27%, p=0.0001). Also, PCI-related myocardial infarction [i.e., post procedural increase in CK-MB>3 times above the URL] tended to be lower in the ranolazine versus placebo group: 1.8% versus 5.45%, P=0.0002. 24 hours post procedural levels of cardiac markers were also significantly lower in the ranolazine versus control group (CK-MB: 2.42±2.05 versus 7.02±9 ng/ml, P=0.001; Troponin 1: 0.447±0.74 versus 1.18±1.6 ng/ml, P=0.004). No significant adverse effect of the drug was reported. Conclusion: So, we have concluded that ranolazine was effective in significantly reducing the periprocedural myocardial injury in elective PCI. Anwer Khan Modern Medical College Journal Vol. 10, No. 1: Jan 2019, P 43-49

scholarly journals Influence of Stent Length on Peri-Procedural Myocardial Injury after Percutaneous Coronary Intervention

2014 ◽  
Vol 6 (2) ◽  
pp. 143-148
Author(s):  
MRM Mandal ◽  
MA Rahman ◽  
MAK Akanda ◽  
M Ullah ◽  
N Kar
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Myocardial Injury ◽  
Troponin I ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Stent Group ◽  
Percutaneous Coronary ◽  
Stent Length ◽  
Group A ◽  
Group B

Background: About one-third of all elective PCI procedures are associated with significant myocardial injury termed peri-procedural myocardial injury (PMI), which has been associated with increased subsequent mortality. The stent length is one of the factors that can predict procedure related Troponon I release. Methods: This interventional study was carried out to evaluate the influence of stent length on peri– procedural myocardial injury by measuring post procedural release of Troponin I after percutaneous coronary intervention. Patients with e”70% stenosed single vessel disease undergoing percutaneous coronary intervention with single stent were considered. Exclusion criteria were pre-procedural elevation of cardiac Troponin I above the 99th percentile of upper reference, severely ill patients. Total 90 consecutive patients were included. Among them 45 patients had d” 20mm long stent (group A) and rest 45 patients had > 20mm long stent (group B). Blood samples for Troponin I were collected before procedure and 12 hours after procedure. Results: Baseline characteristics including age, sex, risk factor for ischaemic heart disease and clinical diagnoses were almost similar between the two groups. During procedure no complications concurred 93.3% patients in group A and 68.9% patients in group B (p<0.05). Post procedural Troponin I level in group A was 0.47 ± 0.54 and in group B was 0.99 ± 1.09 (p<0.05). The stent length and post procedural Troponin I level had moderate correlation (r=0.41) (p<0.05). In hospital complications in two groups include persistent angina (6.7% vs. 11.1%), new ischaemic episode (0.0% vs. 4.4%) (p>0.05). There were no myocardial infarction, acute left ventricular failure, emergency CABG, arrhythmia and death in both groups. Durations of hospital stay were significantly higher in group B then group (4.53 ± 0.63 vs. 4.07 ± 0.65, p<0.05). Conclusion: The incidence of procedural myocardial injury and procedural complications are more in longer stent group. So limiting the stent length by spot-stenting the lesions rather than covering the entire vessel between lesions may reduce peri-procedural release of cTnI and improve post procedural prognosis. DOI: http://dx.doi.org/10.3329/cardio.v6i2.18358 Cardiovasc. j. 2014; 6(2): 143-148

scholarly journals Acute Pericarditis after Percutaneous Coronary Intervention: A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 490
Author(s):  
Greta Rodevič ◽  
Povilas Budrys ◽  
Giedrius Davidavičius
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Chest Pain ◽  
Troponin I ◽  
Stable Condition ◽  
Coronary Intervention ◽  
Prior History ◽  
Acute Pericarditis ◽  
St Segment Elevation ◽  
St Segment ◽  
Percutaneous Coronary

Background: Percutaneous coronary intervention (PCI) is known as a very rare possible trigger of pericarditis. Most frequently it develops after a latent period or early in the case of periprocedural complications. In this report, we present an atypical early onset of pericarditis after an uncomplicated PCI. Case Summary: A 58-year-old man was admitted to the hospital for PCI of the chronic total occlusion of the left anterior descending (LAD) artery. An initial electrocardiogram (ECG) was unremarkable. The PCI attempt was unsuccessful. There were no procedure-related complications observed at the end of the PCI attempt and the patient was symptom free. Six hours after the interventional procedure, the patient complained of severe chest pain. The ECG demonstrated ST-segment elevation in anterior and lateral leads. Troponin I was mildly elevated but a coronary angiogram did not reveal the impairment of collateral blood flow to the LAD territory. Due to pericarditic chest pain, typical ECG findings and pericardial effusion with elevated C-reactive protein, the diagnosis of acute pericarditis was established, and a course of nonsteroidal anti-inflammatory drugs (NSAIDs) was initiated. Chest pain was relieved and ST-segment elevation almost completely returned to baseline after three days of treatment. The patient was discharged in stable condition without chest pain on the fourth day after symptom onset. Conclusions: Acute pericarditis is a rare complication of PCI. Despite the lack of specific clinical manifestation, post-traumatic pericarditis should be considered in patients with symptoms and signs of pericarditis and a prior history of iatrogenic injury or thoracic trauma.

scholarly journals Long-Term Prognosis in Young Patients with Stable Coronary Disease: Ten-Year Follow-up of Percutaneous Coronary Intervention

2012 ◽  
Vol 20 (2) ◽  
pp. 161-165 ◽  
Author(s):  
Igor Ribeiro de Castro Bienert ◽  
Expedito E. Ribeiro ◽  
Luiz J. Kajita ◽  
Marco Antonio Perin ◽  
Carlos A.H. Campos ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Disease ◽  
Young Patients ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Long Term Prognosis
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