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MI post CABG or PCI







Myocardial infarction can also be classified as occurring in the setting of percutaneous coronary intervention (Type 4) and coronary artery bypass grafting (Type 5).  What are the diagnostic criteria in these settings?


  • In the setting of percutaneous coronary interventions (PCI) and normal baseline troponins, myocardial ischemia may be classified as myocardial necrosis (BM > 99URL) or MI (BM > 3 × 99URL). ( BM = biomarkers and URL = upper reference limit).  There is a subtype of MI related to documented stent thrombosis. 
  • In the setting of coronary artery bypass grafting (CABG) and normal baseline troponins, myocardial ischemia may be classified as myocardial necrosis (BM > 99URL) or MI(BM > 5 × 99URL). In addition to biomarker criteria, MI must have one of the following:
    • New pathological Q waves or new LBBB
    • Angiographically documented new graft or native coronary artery occlusion
    • Imaging evidence of new loss of viable myocardium





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