Coronary Angiography in Critically Ill Patients With Type II Myocardial Infarction

Study type: prospective cohort and randomized trial. Duration: estimated 2 years. Indications: Type II myocardial infarction in critically ill patients. Purpose:

• Primary endpoint: to demonstrate that percutaneous coronary intervention (PCI) in the group with obstructive coronary disease reduces the size of MI.
• Secondary endpoints: improved cardiac function after revascularization, shorter hospitalization, reduced mortality.
• Safety objective: renal function, bleeding complications. Population: 140 patients with type II MI over 18 years of age with no evidence of active bleeding. Inclusion criteria:
• age\> 18 years
• High sensitive troponin I \> 40 ng / L for women and \> 58ng / L for men
• Critical illness (at least one vital organ support)
• Imaging signs (electrocardiogram or ultrasound) signs of myocardial ischemia Exclusion criteria:
• active bleeding
• terminal illness Monitoring of patients: during hospitalization, 30 days after discharge, 6 months after discharge. Performance check:
• PCI success (% of "thrombolysis in myocardial infarction" flow 3)
• the size of MI (troponin area under the curve)
• left ventricular ejection fraction
• hospital stay
• 30 day survival Safety Check:
• monitoring of renal function
• monitoring of bleeding complications
• monitoring of allergic reactions to contrast and medication Patient Consent: written informed consent for inclusion in the study in conscious population. In unconscious patients, written consent will be obtained in the event of mental function improvement.