Left ventricular myocardial performance index for assessment of acute periprocedural outcomes in coronary artery disease patients after successful percutaneous coronary intervention

To investigate prospectively the improvement of myocardial performance index (MPI) in coronary artery disease (CAD) patients after successful percutaneous coronary intervention (PCI), to assess prognostic value of MPI in predicting acute periprocedural adverse events and to analyze influence of other correlating factors on MPI and its post PCI improvement. After patient selection, detailed clinical history was taken and risk factors (diabetes mellitus (DM), hypertension (HTN), smoking, obesity) were noted. Body mass index was measured. Baseline ST segment deviation in 12 lead electrocardiogram (ECG) on the day of PCI was calculated. MPI, left ventricular ejection fraction (LVEF), wall motion score index (WMSI) were measured serially one day before PCI and one day after successful PCI. A total of 101 patients with CAD were included in the study. Age, sex, diabetic status, presence of HTN and degree of ST segment deviation did not affect the baseline MPI but New York heart association (NYHA) class III (p = 0.04), WMSI (p = 0.002), LVEF (p < 0.05), degree of stenosis (p = 0.05) and diastolic dysfunction Grade III (p < 0.001) had significant influence on MPI. A significant positive correlation was observed between baseline MPI and WMSI (standardized β coefficient 0.3, p = 0.002). Significant negative correlation was found between baseline MPI and ejection fraction of left anterior descending artery (LAD) group (standardized β coefficient = 0.47, p < 0.05). On Cox univariate regression analysis, we identified baseline WMSI (p = 0.01) and presence of American College of Cardiology Class (ACC)-C lesions (p = 0.02) as independent predictors of adverse outcome after PCI. Neither baseline MPI (p = 0.29) nor post PCI MPI (p = 0.79) was independently related to adverse outcomes in this study model. In current era of stenting, neither baseline nor post PCI MPI can predict acute periprocedural adverse events. WMSI and complex lesion morphology are good predictors of acute periprocedural adverse outcomes.