ABSTRACT
Background: About one-third of all elective PCI procedures are associated with significant myocardial injury termed peri-procedural myocardial injury (PMI), which has been associated with increased subsequent mortality. The stent length is one of the factors that can predict procedure related Troponon I release. Methods: This interventional study was carried out to evaluate the influence of stent length on peri– procedural myocardial injury by measuring post procedural release of Troponin I after percutaneous coronary intervention. Patients with e”70% stenosed single vessel disease undergoing percutaneous coronary intervention with single stent were considered. Exclusion criteria were pre-procedural elevation of cardiac Troponin I above the 99th percentile of upper reference, severely ill patients. Total 90 consecutive patients were included. Among them 45 patients had d” 20mm long stent (group A) and rest 45 patients had > 20mm long stent (group B). Blood samples for Troponin I were collected before procedure and 12 hours after procedure. Results: Baseline characteristics including age, sex, risk factor for ischaemic heart disease and clinical diagnoses were almost similar between the two groups. During procedure no complications concurred 93.3% patients in group A and 68.9% patients in group B (p<0.05). Post procedural Troponin I level in group A was 0.47 ± 0.54 and in group B was 0.99 ± 1.09 (p<0.05). The stent length and post procedural Troponin I level had moderate correlation (r=0.41) (p<0.05). In hospital complications in two groups include persistent angina (6.7% vs. 11.1%), new ischaemic episode (0.0% vs. 4.4%) (p>0.05). There were no myocardial infarction, acute left ventricular failure, emergency CABG, arrhythmia and death in both groups. Durations of hospital stay were significantly higher in group B then group (4.53 ± 0.63 vs. 4.07 ± 0.65, p<0.05). Conclusion: The incidence of procedural myocardial injury and procedural complications are more in longer stent group. So limiting the stent length by spot-stenting the lesions rather than covering the entire vessel between lesions may reduce peri-procedural release of cTnI and improve post procedural prognosis.