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Advanced Technical IVT

periprocedural myocardial infarction

Myocardial injury occurring in association with percutaneous coronary intervention or cardiac surgery.

Full Definition

Periprocedural myocardial infarction refers to myocardial injury that occurs in temporal association with percutaneous coronary intervention (type 4a MI) or coronary artery bypass surgery (type 5 MI) according to the Fourth Universal Definition of Myocardial Infarction. The diagnosis requires elevation of cardiac biomarkers (preferably high-sensitivity troponin) above the 99th percentile upper reference limit in patients with normal baseline values, or a rise >20% if baseline values are elevated. Additional criteria may include new Q waves, new LBBB, angiographic evidence of flow-limiting complications, or imaging evidence of new wall motion abnormalities. Periprocedural MI may result from side-branch occlusion, distal embolization, coronary dissection, or other procedural complications.

Usage

Usage note: Specify type 4a (PCI-related) or type 5 (CABG-related) according to universal definition

In Context

  • "Troponin elevation consistent with type 4a periprocedural myocardial infarction was detected." — Post-procedural assessment
  • "Side-branch occlusion during stent deployment resulted in periprocedural myocardial infarction." — Complication report

Also known as

procedural MI type 4a MI type 5 MI

Don't confuse with

spontaneous MI contrast-induced nephropathy

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