Prognostic importance of troponin T and creatine kinase after elective angioplasty

Nienhuis, Mark B.; Ottervanger, Jan Paul; Dikkeschei, Bert D.; Suryapranata, Harry; Boer, Menko‐Jan de; Dambrink, Jan‐Henk E.; Hoorntje, Jan C.A.; Hof, Arnoud W J van ‘t; Gosselink, Marcel; Zijlstra, Felix

doi:10.1016/j.ijcard.2006.10.002

Cited by 21 publications

(20 citation statements)

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“…An increase in troponin following PCI has been convincingly shown to indicate myocyte death [3] and as this necrosis occurs secondary to myocardial ischemia, it should accordingly be labeled as myocardial infarction. Previous studies have documented troponin release following intervention in 13 to 66% of patients [1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. These studies used either troponin T (TnT) and/or troponin I measurements, with a wide range of cut-offs for determining a significant troponin rise: for TnT, cut-offs ranged between 0.01 and 0.2 ng/ml, including a study by Miller et al using a TnT cutoff of 0.03 ng/ml, in which 41% had an elevation post-PCI [21].…”

Section: Introductionmentioning

confidence: 99%

“…Troponin elevation following PCI is an important predictor of adverse in-hospital cardiac events including death, acute myocardial infarction and target lesion revascularization [4,5,13,14], as well as longer-term adverse outcomes including readmission for angina and acute myocardial infarction [6], repeat PCI, bypass surgery and cardiac death up to one year following intervention [5,10,14,17,25,26]. There is conflicting evidence from a study by Cavallini et al, in which cardiac troponin elevation following PCI did not influence two-year mortality [18], and Miller et al finding those with late elevations in TnT post-PCI were associated with a small increase of only in-hospital mortality, but not long-term events [21].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Incidence and determinants of myocardial infarction following percutaneous coronary interventions according to the revised Joint Task Force definition of troponin T elevation

Alcock

Roy

Adorini

et al. 2010

International Journal of Cardiology

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incidence and determinants of myocardial infarction following percutaneous coronary interventions according to the revised Joint Task Force definition of troponin T elevation

Alcock

Roy

Adorini

et al. 2010

International Journal of Cardiology

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“…The design of our study includes the advantage of pre-and post-procedural biomarker measurement, allowing for the potential that hsTn I measurement may identify new, significant myocardial necrosis as early as the conclusion of the procedure. Some have indeed argued that much of the risk associated with peri-procedural troponin elevation is due to myocardial necrosis prior to the procedure [26] while others argue that post-procedure troponin elevation may strongly predict future clinical outcomes [27]; there is thus uncertainty regarding the appropriate interpretation of elevated troponin after revascularization.…”

Section: Discussionmentioning

confidence: 99%

Design, methods, baseline characteristics and interim results of the Catheter Sampled Blood Archive in Cardiovascular Diseases (CASABLANCA) study

Gaggin

Bhardwaj

Belcher

et al. 2014

IJC Metabolic & Endocrine

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a b s t r a c tBackground: The ability to identify peri-procedural complications or predict short and long-term adverse outcomes in patients undergoing cardiac or peripheral angiography is imperfect. Methods: In a prospective single-center trial, 1251 subjects undergoing coronary and peripheral angiographic procedures ± intervention between 2008 and 2011 were enrolled to evaluate the use of cardiac and renal biomarkers for identifying peri-procedural events and predicting short and long-term events. Blood samples were taken immediately before and after the procedure. Clinical and angiographic characteristics were recorded. The primary end point is peri-procedural combined end point of major adverse cardiovascular events (MACE: death, myocardial infarction (MI), heart failure (HF), stroke, transient ischemic attack, peripheral arterial complication and cardiac arrhythmia). Secondary end points are assessed at peri-procedural, 30-day and 1-year, and include MACE and individual end points as well as renal complications including acute kidney injury (AKI) and worsening of chronic kidney disease. Extended follow-up of up to 6 years has also been completed. Results: Data from the first 491 patients have been obtained with 190 patients experiencing at least one MACE at 1-year follow-up with the following number of patients experiencing at least one specified event; 80 deaths, 39 MI, 73 HF, 21 neurological events, 37 peripheral arterial complications and 59 arrhythmias; additionally there were 55 patients with AKI. Conclusions: The CASABLANCA study will examine the role of novel biomarkers and metabolomics for predicting a wide range of cardiovascular, neurologic, and renal complications in patients undergoing angiography. Full results are expected in the latter half of 2014 (Clinical Trials.Gov # NCT00842868).

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“…Post-procedural elevations of cTns levels occur in 5% to 50% of subjects undergoing percutaneous coronary intervention (PCI) (Califf et al, 1998). The association between cTns elevation after elective PCI and cardiac events is conflicted during the follow-up (Fuchs et al, 2000;Nallamothu et al, 2003;Ramírez-Moreno et al, 2004;Prasad et al, 2006;Nienhuis et al, 2007;Milani et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

A correlation between acute kidney injury and myonecrosis after scheduled percutaneous coronary intervention

Zhang

Meng

Zhao

et al. 2013

J. Zhejiang Univ. Sci. B

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Slight elevations in cardiac troponin I and T are frequently observed after percutaneous coronary intervention (PCI). Contrast-induced acute kidney injury (CI-AKI) is a complex syndrome induced by exposure to intravascular contrast media (CM). Currently, the relationships between the CM, pre-existing kidney insufficiency, CI-AKI, and myonecrosis after elective PCI are unclear. To investigate the relationship between CI-AKI and post-procedural myonecrosis (PMN) after PCI, we analyzed 327 non-ST-segment elevation acute coronary syndrome subjects undertaking elective PCI. The levels of cardiac troponins (cTns), cTnI and cTnT, at baseline and on at least one occasion 18-24 h after PCI were measured. We also recorded serum levels of creatinine (SCr) and the urine albumin:creatinine ratio (ACR) before coronary angiography, and 24-48 h and 48-72 h after contrast administration. A post-procedure increase in cTns was detected in 16.21% (53/327) of subjects with cTns levels >99th to 599th percentile upper reference limit (URL). Twenty-seven patients (8.26%) developed CI-AKI. CI-AKI occurred more often in subjects with PMN than in those without PMN (20.8% versus 5.8%, respectively, P=0.001). Multiple logistic regression analysis revealed that pre-existing microalbuminuria (MA) was an important independent predictor of PMN (OR: 3.31; 95% CI: 1.26-8.65, P=0.01). However, there was no correlation between the incidence of CI-AKI and PMN (OR: 2.38; 95% CI: 0.88-6.46, P=0.09). We conclude that pre-existing MA was not only an important independent predictor of CI-AKI but also of PMN.

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Prognostic importance of troponin T and creatine kinase after elective angioplasty

Cited by 21 publications

References 44 publications

Incidence and determinants of myocardial infarction following percutaneous coronary interventions according to the revised Joint Task Force definition of troponin T elevation

Incidence and determinants of myocardial infarction following percutaneous coronary interventions according to the revised Joint Task Force definition of troponin T elevation

Design, methods, baseline characteristics and interim results of the Catheter Sampled Blood Archive in Cardiovascular Diseases (CASABLANCA) study

A correlation between acute kidney injury and myonecrosis after scheduled percutaneous coronary intervention

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