Mild myocardial injury during percutaneous coronary intervention based on minor changes on electrocardiogram and heart rate variability.

BACKGROUND

As cardiovascular mortality continues to increase globally, percutaneous coronary intervention (PCI) with stent placement stands out as a cutting-edge and highly effective treatment for severe cardiovascular diseases. However, the inherent invasiveness of any endovascular procedure introduces the risk of coronary vessel and myocardial damage.

AIM: To evaluate the utility of a novel electrocardiographic metric in detecting subtle myocardial injuries after coronary stenting.

METHODS

This investigation was conducted in 2021 at the Kyiv Heart Institute of the Ministry of Healthcare of Ukraine. The study involved 23 patients who underwent PCI, each subjected to a meticulous preoperative examination. A paired measurement approach was employed, encompassing 3-minutes electrocardiogram (ECG) recordings both before and several hours following the operation, using a compact ECG device. Each pair of ECG underwent a thorough analysis, scrutinizing 240 primary and computed ECG parameters.

RESULTS

The analysis delineated a distinct subgroup exhibiting significant myocardial damage post-stenting. This subgroup was characterized by an older average age and more stents than their counterparts. Notably, a concurrent reduction in the psychoemotional state index was observed alongside the ECG alterations in these patients, suggesting a correlation between myocardial damage and psychoemotional distress. Introducing a new electrocardiographic index has illuminated the often-subtle myocardial damage incurred during PCI.

CONCLUSION

The newly devised electrocardiographic metric is a significant advancement in the early detection of myocardial damage following PCI, able to capture not only physiological but also psychoemotional changes.