• Naeem Asghar Madina Teaching Hospital, UMDC Faisalabad.
  • Muhammad Nazim Wazir Abad Institute of Cardiology, Wazir Abad
  • Shakeel Ahmad Faisalabad Institute of Cardiology, Faisalabad.



Myocardial infarction (MI),, Percutaneous coronary intervention (PCI),, Cardiac enzyme,, Periprocedural myonecrosis


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

Author Biographies

Naeem Asghar, Madina Teaching Hospital, UMDC Faisalabad.

MBBS, FCPS (Cardiology)
Assistant Prof. Cardiology

Muhammad Nazim, Wazir Abad Institute of Cardiology, Wazir Abad

MBBS, FCPS (Cardiology)
Senior Registrar Cardiology

Shakeel Ahmad, Faisalabad Institute of Cardiology, Faisalabad.

MBBS, FCPS (Cardiology)
Senior Registrar,
Cardiology Department,