Predictors and Prognostic Significance of Troponin-I Release following Elective Coronary Angioplasty

Abstract

The objective of this study was to investigate the predictors and prognostic significance of post-procedural cardiac troponin (cTn)-I elevations in a consecutive series of patients who underwent elective percutaneous coronary intervention (PCI). cTn-I was measured in 100 patients immediately before and within 24 h after the elective PCI. Post-procedural cTn-I elevation was observed in 27 of the 100 patients. In multivariate analysis, basal haemoglobin values and the number of repeated balloon dilatations were found to be independent predictors of cTn-I elevation. During the followup period of 12 ± 1.2 months, the cTn-I-positive group had more major adverse cardiovascular events than the cTn-I-negative group (33.3% versus 16.4%, respectively), but the difference was not significant. An increase in cTn-I levels following elective PCI procedures was frequent but did not predict a poor longterm outcome.

Prognostic value of troponin after elective percutaneous coronary intervention: A meta‐analysis

“…Twenty studies were included in our analysis [10,[12][13][14][15][16][17][18][19]21,[23][24][25][26][27][28][29][34][35][36], concerning 17 prospectively and 3 retrospectively performed studies. These studies were published between 1998 and 2007.…”

Prognostic value of cardiac troponin‐I or troponin‐T elevation following nonemergent percutaneous coronary intervention: A meta‐analysis

“…Of 420 citations identified, 22 studies were included in our analysis [16–39], including 15 prospective and 7 retrospective studies published between 1998 and 2009. All the included publications were registry/cohort studies.…”

“…Large thrombus burden as in patients undergoing PCI for ST‐elevation MI or PCI in saphenous vein grafts has frequently been associated with post‐PCI cardiac marker elevations [48]. In addition to atherosclerotic plaque burden, more aggressive intervention (rotational atherectomy device use, multilesion PCI, stent use, multiple stents, larger balloon/artery ratio, balloon inflation time, and larger final balloon size) have been reported to be predictive of greater levels of cTn elevation [16–29]. However, the use of interventional devices and techniques is often driven by the extent of the disease (e.g.…”

“…In contrast, the association between cTn elevation after elective PCI and long‐term cardiac events is not well defined and conflicting data have been published [16–39]. The preponderance of evidence from early studies evaluating ACS patient populations suggests that cTnI elevation post‐PCI does not provide long‐term prognostic information regarding mortality [16–18, 20–31]. However, more recently, several reports have suggested that an isolated cTnI elevation after PCI may be a predictor of long‐term mortality [32, 33].…”

Effect of Intracoronary Nicardipine on Cardiac Enzymes After Elective Percutaneous Coronary Intervention

“…Previous studies have shown that use of statins prior to PCI may have protective effects, 6 while both postdilatation and longer stent length increase the incidence of cardiac enzyme leakage after PCI. 15,16 Therefore, these differences could have affected the results of the study. Moreover, the potential beneficial effects may be underestimated secondary to lower overall incidence of myonecrosis in our study population.…”