Recent advances in the diagnosis and treatment of acute myocardial infarction

Table 4 Proposed definition of clinically relevant myocardial infarction after both percutaneous coronary intervention and coronary artery bypass grafting procedures

In patients with normal baseline CK-MB	The peak CK-MB measured within 48 h of the procedure rises to ≥ 10 × the local laboratory ULN, or to ≥ 5 × ULN with new pathologic Q-waves in ≥ 2 contiguous leads or new persistent LBBB, OR in the absence of CK-MB measurements and a normal baseline cTn, a cTn (I or T) level measured within 48 h of the PCI rises to ≥ 70 × the local laboratory ULN, or ≥ 35 × ULN with new pathologic Q-waves in ≥ 2 contiguous leads or new persistent LBBB
In patients with elevated baseline CK-MB (or cTn) in whom the biomarker levels are stable or falling	The CK-MB (or cTn) rises by an absolute increment equal to those levels recommended above from the most recent pre-procedure level
In patients with elevated CK-MB (or cTn) in whom the biomarker levels have not been shown to be stable or falling	The CK-MB (or cTn) rises by an absolute increment equal to those levels recommended above plus new ST-segment elevation or depression plus signs consistent with a clinically relevant MI, such as new onset or worsening heart failure or sustained hypotension

ULN: Upper limit of normal; MI: Myocardial infarction; cTn: Cardiac troponin.