Stage 6 — Evaluate outcomes. Review the 6-hour post-PCI monitoring trend and answer the two evaluation questions.
Trend
Choose your responses, then check the answer.
Explanation
Normal Post-PCI Course ST elevation resolution + HR·BP stabilization = successful reperfusion. Troponin surge (peak at Hour 2-4) = post-reperfusion washout — not reinfarction. Troponin decline starting at Hour 6 = further confirmation of reperfusion success. Urine output maintained = signal of maintained cardiac output.
NCJMM Stage 6 — Evaluate Outcomes Troponin elevation post-PCI is normal due to washout after reperfusion. Suspect re-infarction: ST re-elevation + recurrent chest pain + new hemodynamic deterioration. Dual antiplatelet therapy (DAPT): Maintain for at least 12 months post-PCI — continuous monitoring essential.
Scenario (Stage 6 — Evaluate outcomes)Review the 6-hour monitoring trends after successful primary PCI.
재관류 후 트로포닌 상승 — PCI 성공 후 트로포닌은 세포 내 트로포닌 혈류로 방출되어 일시적 급상승(washout). 재경색의 트로포닌 상승: 하강 후 재상승 패턴 + 증상 재발.
PCI 성공 지표 — ST 해소(≥ 50% 감소), 흉통 소실, 혈역학 안정, 트로포닌 피크 후 하강, 소변량 유지.
DAPT 유지 기간 — PCI(DES) 후 DAPT 최소 12개월. 출혈 고위험 시 6개월 고려. DAPT 중단 or 중단 필요 시 심장전문의와 상의 필수.