Assessment of Peri-Procedural Myocardial Injury by High-Sensitivity Troponin-I Levels after Successful Elective Percutaneous Transluminal Coronary Angioplasty

Objective: To determine the incidence of Peri-Procedural Myocardial Injury (PMI) after elective, successful Percutaneous Transluminal Coronary Angioplasty (PTCA) as assessed by High Sensitivity troponin-I (HS-Trop-I) levels, and to find out association between PMI and clinical, angiographic and procedural variables. Study Design: Analytical Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi Pakistan, from Dec 2022 to Jun 2023. Methodology: Total one hundred and thirty-one cases were included using consecutive sampling technique. Patients with stable angina and having at least one positive stress test, baseline pre-PCI cardiac troponin level below the 99th percentile upper reference limit (normal baseline troponin), and a target lesion with a stenosis of >70% on qualitative angiography were included in study. Patients were divided into two groups; (Group-I=HS-Trop-I>40ng/L and Group-II=HS-Trop-I≤40 ng/L). Independent samples t-test and Pearson’s Chi-square test were applied to compare the study variables among study groups and p<0.05 was considered as statistically significant. Results: PMI was reported in 60(45.8%) out of 131 patients. Hypertension and previous myocardial infarction demonstrated slightly higher prevalence in group-I but there was insignificant difference in frequencies of demographics and comorbid in study groups (p>0.05). Total stent length and max balloon time, were significantly higher in the group-I (50.73±25.19mm vs 31.13±17.83mm; 26.80±7.51sec vs 22.42±5.94sec respectively) (p<0.001). There was also statistically significant difference in frequency of AHA classification, number of diseased vessels and multi-vessel PCI in study groups (p<0.001). Conclusion: PMI is a common complication of elective PCI, especially when patients present with high-risk......