Clinical outcome of patients with elevated cardiac markers after percutaneous coronary intervention

Aim: to determine early clinical outcome in patients with normal and elevated cardiac enzymes after percutaneous coronary intervention (pci).methods: from february 2009 to january 2010,total of 200 consecutive patients fulfilling the inclusion and exclusion criteria,who underwent pci at punjab institute of cardiology,lahore were included in this survey. a prospective observational study was carried. patients were divided into two groups randomly. the blood sample was drawn within 24 hours of the procedure and creatine kinase-myocardial band (ckmb) level was analyzed. based on cardiac enzyme level,patients were divided into two groups; 150 patients in group i with normal ck-mb level and 50 patients in group ii above the upper reference limit. the primary end point of the study was in-hospital or 30 day mortality. secondary clinical end points were major adverse cardiac events (mace) including q-wave and non-q-wave myocardial infarction,emergent coronary artery bypass operation,or repeat target lesion revascularization (tlr) at 30 days after the index operation.results: during the study,out of 150 patients in group i,periprocedural complications were dissection (6%),side branch compromise (14%),slow flow (10%),no reflow (2%),sub-acute stent thrombosis (4%). in the other hand,out of 50 patients in group ii,slow flow was seen in 1.4% and sub-acute stent thrombosis in 0.7%. 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 the group i. 6% patients needed repeat target lesion revascularization in group ii and only 0.7% in group i.conclusions: the findings confirm that raising cardiac enzymes had a worse clinical outcome in terms of mortality,myocardial infarction and repeat target lesion revascularization as compared to normal cardiac enzymes post pci. © 2014 pakistan journal of medical and health sciences. all rights reserved.