Document Detail

Prognostic importance of troponin T and creatine kinase after elective angioplasty.
MedLine Citation:
PMID:  17182137     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The prognostic importance of elevated cardiac enzymes after elective percutaneous coronary intervention has been debated. Therefore, we performed a prospective observational study to evaluate the prognostic value of postprocedural rise of troponin T and creatine kinase. METHODS: Troponin T (cut-off value 0.05 ng/ml) and creatine kinase (cut-off value 180 IU/l with muscle-brain fraction >4%) were measured 12 h after elective percutaneous coronary intervention in 713 consecutive patients without elevated troponin before the procedure. Primary endpoint was the combined incidence of death, myocardial infarction, stroke, repeat angiography or re-admission because of anginal symptoms during the follow-up period. RESULTS: Troponin was elevated after the procedure in 150 patients (21%) and creatine kinase in 66 pts (9%), with a strong association between increased troponin and creatine kinase. After a mean follow-up of 10.9 months, mortality was low (1%) and not associated with increased troponin or creatine kinase. There was, however, a strong relation between postprocedural troponin and re-admission for angina (p=0.001) or myocardial infarction (p=0.001). Furthermore, troponin rise was significantly associated with an increased risk of the primary endpoint (relative risk 1.55 95% confidence interval 1.01-2.38). After multivariate analysis, troponin elevation but not increased creatine kinase was associated with an increased risk of the primary endpoint (relative risk 1.59 95% confidence interval 1.02-2.47 for troponin elevation versus 1.16 95% confidence interval 0.62-2.15 for increased creatine kinase). CONCLUSION: Increase of troponin T after elective percutaneous coronary intervention has stronger prognostic implication when compared to increased creatine kinase.
Mark B Nienhuis; Jan Paul Ottervanger; Bert Dikkeschei; Harry Suryapranata; Menko-Jan de Boer; Jan-Henk E Dambrink; Jan C A Hoorntje; Arnoud W J van 't Hof; Marcel Gosselink; Felix Zijlstra
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Publication Detail:
Type:  Journal Article     Date:  2006-12-19
Journal Detail:
Title:  International journal of cardiology     Volume:  120     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-16     Completed Date:  2007-08-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  242-7     Citation Subset:  IM    
Department of Cardiology, Isala klinieken, Groot Wezenland 20, 8011 JW Zwolle, The Netherlands.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary*
Biological Markers / blood
Coronary Angiography
Coronary Disease / blood*,  diagnosis,  therapy
Creatine Kinase / blood*
Follow-Up Studies
Middle Aged
Prospective Studies
Severity of Illness Index
Troponin T / blood*
Reg. No./Substance:
0/Biological Markers; 0/Troponin T; EC Kinase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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