According to the 4th Universal Definition of MI, a rise and fall in troponin with at least one value above the 99th percentile URL is required. Which MI type is defined by biomarker elevation following CABG?

• A Type 4a MI
• B Type 2 MI
• C Type 3 MI
• D Type 5 MI ✓

Explanation

Per the 4th Universal Definition of MI (ESC/ACC/AHA 2018): Type 1 = spontaneous atherothrombotic; Type 2 = supply-demand mismatch; Type 3 = sudden cardiac death before biomarkers; Type 4a = peri-PCI; Type 4b = stent thrombosis; Type 4c = stent restenosis; Type 5 = peri-CABG (troponin >10× URL with new Q waves or new LBBB or new graft occlusion/native vessel occlusion on angiography). Type 4a is PCI-related, not CABG.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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