Table 2.

Myocardial infarction

Peri-procedural MI (≤72 h After the index procedure)

New ischaemic symptoms (e.g. chest pain or shortness of breath), or new ischaemic signs (e.g. ventricular arrhythmias, new or worsening heart failure, new ST-segment changes, haemodynamic instability, or imaging evidence of new loss of viable myocardium or new wall motion abnormality),

AND

Elevated cardiac biomarkers (preferably CK-MB) within 72 h after the index procedure, consisting of two or more post-procedure samples that are >6–8 h apart with a 20% increase in the second sample and a peak value exceeding 10x the 99th percentile upper reference limit (URL), or a peak value exceeding 5x the 99th percentile URL with new pathological Q waves in at least two contiguous leads.

Spontaneous MI (>72 h after the index procedure)

Any one of the following criteria:

Detection of rise and/or fall of cardiac biomarkers (preferably troponin) with at least one value above the 99th percentile URL, together with evidence of myocardial ischaemia with at least one of the following:

ECG changes indicative of new ischaemia [new ST-T changes or new left bundle branch block (LBBB)]

New pathological Q waves in at least two contiguous leads

Imaging evidence of new loss of viable myocardium or new wall motion abnormality

Sudden, unexpected cardiac death, involving cardiac arrest, often with symptoms suggestive of myocardial ischaemia, and accompanied by presumably new ST elevation, or new LBBB, and/or evidence of fresh thrombus by coronary angiography and/or at autopsy, but death occurring before blood samples could be obtained, or at a time before the appearance of cardiac biomarkers in the blood.

Pathological findings of an acute myocardial infarction.