Baseline inflammation is not predictive of periprocedural troponin elevation after elective percutaneous coronary intervention

Abstract

High-sensitivity C-reactive protein predicts future cardiovascular events in both healthy individuals and patients with unstable and stable coronary syndromes. Few data are available about the incidence and the relation to infl ammation of troponin elevation following percutaneous coronary intervention (PCI), a potential predictor of longterm outcome. We sought to confi rm the impact of embolization on long-term outcome and evaluate the ability of baseline infl ammation to predict troponin elevation induced by PCI. We prospectively analyzed 200 patients treated by PCI for stable or Braunwald IIA class unstable angina. The patients were recruited between January 1997 and May 1999, and the population was followed during a mean follow-up of 32 months. Major adverse cardiac events (MACEs) were defi ned as the occurrence of death, myocardial infarction or recurrent angina requiring repeat PCI, or coronary artery bypass grafting. During the follow-up period, 58 MACEs were observed. By multivariate analysis, independent predictors for the occurrence of MACEs were unstable angina and troponin I level after PCI (P < 0.0001 for both). No correlation was found between baseline infl ammation and signifi cant troponin I elevation post PCI and by multivariate analysis, no biological variable was a predictor of troponin I elevation post PCI. Baseline infl ammation cannot predict onset of minor myonecrosis damage (expressed by troponin elevation) induced by PCI, a significant predictor of long-term outcome in this setting.

Predictive value of baseline C-reactive protein for periprocedural myocardial infraction of higher risk stratifications: A retrospective cohort clinical study

“…However, altogether 208 patients were included in the study done by Goldberg et al ( 22 ), thus, the relatively smaller sample size may influence the authenticity of their study. Similar studies aiming at the relation between CRP and troponin elevations reached opposite conclusions ( 16 , 17 , 20 , 28 ).…”

“…However, previous studies examining the relationship between preprocedural CRP level and periprocedural myocardial injury (mainly minor PMN and the 2007 universal PMI) reported controversial conclusions, with different cardiac enzymes, various cut-offs of CRP, and relatively smaller samples ( 16 - 18 , 20 , 22 , 27 , 28 ). For instance, the results from the study done by Goldberg et al ( 22 ) which used >4.6 mg/L as a CRP cutoff was contradictory to that from other previous large sample size studies which used >3 mg/L as a CRP cutoff in patients with stable angina ( 13 , 25 , 26 ).…”

Association of baseline C‐reactive protein levels with periprocedural myocardial injury in patients undergoing percutaneous bifurcation intervention: A CACTUS study subanalysis

“…Among factors affecting baseline risk, systemic inflammatory status as assessed by baseline levels of CRP, has been associated with more periprocedural complications after PCI . Six previous studies have evaluated the association of baseline CRP both with cardiac troponin and CK‐MB rise . Of these studies, five have been performed with troponin I or T as a biomarker of myocardial injury, whereas only one study assessed CK‐MB release .…”

“…Six previous studies have evaluated the association of baseline CRP both with cardiac troponin and CK‐MB rise . Of these studies, five have been performed with troponin I or T as a biomarker of myocardial injury, whereas only one study assessed CK‐MB release . However, given the complex anatomy of coronary bifurcations, data obtained in other studies could not been readily transferred to this specific type of lesions.…”