Document Detail

Troponin I elevation and cardiac events after percutaneous coronary intervention.
MedLine Citation:
PMID:  12660677     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Serum troponins are sensitive markers of myonecrosis and ischemia and are now widely used in clinical practice. Although percutaneous coronary intervention (PCI)-related creatine kinase-myocardial band isoenzyme (CK-MB) elevation has been associated with future cardiac events, the significance of troponin elevation in this setting is unknown. We sought to determine whether serum troponin I (Tn-I) elevation after PCI is associated with future cardiac events. Methods and Results Consecutive patients undergoing elective PCI underwent systematic postprocedure measurement of Tn-I and CK-MB levels. Serum levels were correlated with demographic, angiographic, and procedural characteristics and the development of major adverse cardiac events (MACE; defined as death, MI, or need for PCI or coronary bypass graft surgery) at 30 days, 6 months, and 1 year. In 286 consecutive procedures, postintervention myonecrosis-specific Tn-I was elevated in 13.6% of patients, and CK-MB was elevated in 12.9% of patients. Multivariable predictors of Tn-I elevation were procedural side branch occlusion and thrombus formation. Peak Tn-I and CK-MB values were well correlated (r = 0.81, P <.0001). Three-fold elevation of Tn-I after successful PCI was independently predictive of MACE (P =.01).
CONCLUSIONS: Tn-I elevation after elective PCI is relatively common and is associated with procedural complications such as incidental side branch occlusion and thrombus formation. In addition, this study demonstrates that a 3-fold elevation of Tn-I after successful elective PCI is predictive of future cardiac events, especially the need for early repeat revascularization.
Mark J Ricciardi; Charles J Davidson; George Gubernikoff; Nirat Beohar; Lorene J Eckman; Michele A Parker; Robert O Bonow
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  145     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-27     Completed Date:  2003-06-19     Revised Date:  2013-05-20    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  522-8     Citation Subset:  AIM; IM    
Division of Cardiology, Northwestern Memorial Hospital and Northwestern University Medical School, Chicago, Ill 60611, USA.
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MeSH Terms
Aged, 80 and over
Angina Pectoris / blood,  diagnosis
Angioplasty, Balloon, Coronary* / mortality
Biological Markers / blood
Coronary Angiography
Coronary Artery Bypass
Coronary Disease / blood,  surgery,  therapy*
Creatine Kinase / blood*
Creatine Kinase, MB Form
Isoenzymes / blood*
Middle Aged
Myocardial Infarction / blood,  diagnosis*
Myocardial Ischemia / blood,  diagnosis
Prospective Studies
Time Factors
Treatment Outcome
Troponin T / blood*
Reg. No./Substance:
0/Biological Markers; 0/Isoenzymes; 0/Troponin T; EC Kinase; EC Kinase, MB Form

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