The Effect of Systemic Inflammation on the Elevation of Troponin I after Percutaneous Transluminal Coronary Angioplasty with Stent in Patients with Stable Angina

Kim, Young-Choon; Sung, Ki Chul; Park, Seung Ha; Kim, Byung Jin; Kim, Bum Soo; Kang, Jin Ho; Lee, Man Ho; Park, Jung Ro; Park, Hyo Soon; Keum, Dong Keuk; Ryu, Seong Ho; Beck, Sung Ho

doi:10.4070/kcj.2004.34.3.265

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…13 Thus, CRP may be related to such pathological conditions as friability and hypercoagulability of the atheromatous lesion, which predispose to a patient to microembolization or clot formation at the site of the PCI-induced arterial injury. Kim et al 2001 repored that systemic inflammation also provides a link between PCI-associated infarction and long-term events, the same as was reported by previous studies. 14 So, other therapeutic strategies that can inhibit the inflammatory response are needed to prevent periprocedural myocardial injury.…”

Section: Discussionsupporting

confidence: 82%

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Prognostic role of hs-CRP before and after Percutaneous Coronary Intervention in Patients with Stable Angina Pectoris

Das¹,

Zaman²,

Rashid³

et al. 2022

Univ. Heart J.

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Background and Objectives: Myocardial injury after percutaneous coronary intervention (PCI) occurs frequently and it is associated with an adverse clinical outcome. Mechanical factors have been implicated in this complication and the role of inflammation has not yet been clearly determined. We evaluated the effect of an inflammatory response during PCI on periprocedural myocardial injury. Subjects and Methods: This prospective observational study was conducted in the Department of Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh over a period between July’2012 to June’2013. A total of 200 patients studied who underwent elective coronary stenting. For the exclusion of mechanical injury to the myocardium, we excluded those patients who developed complications during PCI. The inflammatory response to PCI was calculated as the difference between the peak postprocedural hs-CRP level and the preprocedural hs-CRP level . We divided the patients according to the median value of hs- CRP: Group I <3 mg/L and Group II >3 mg/L. Results: Postprocedural TnI elevation was were observed in 72 (36%) patients. The baseline clinical and angiographic characteristics were not difference between the two groups. The incidence of any TnI elevations was higher in the Group II than that in Group I (19.8% vs 42.6%, respectively, p<0.001). The incidences of TnI levels over 3 times the upper normal limit and 5 times the upper normal limit were also higher in Group II than in Group I (11.2% vs 21.7%, respectively, p=0.031, for a TnI level 3 times the upper normal limit, and 6.0% vs 13.9%, respectively, for a TnI level 5 times the upper normal limit. Multivariate analysis revealed that postprocedural hs- CRP elevation in high risk group were the significant independent predictors of postprocedural TnI elevation. Conclusion: Elevated hs-CRP levels were associated with a higher risk of postprocedural troponin elevation in patients undergoing uncomplicated PCI. These results emphasized the role of inflammation in the pathogenesis of periprocedural myocardial injury. Measuring of hs-CRP either preprocedural or postprocedural in high risk patients is useful for predicting early cardiovascular events. University Heart Journal 2022; 18(2): 87-92

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Section: Discussionsupporting

confidence: 82%

“…Kim et al 2001 repored that systemic inflammation also provides a link between PCI-associated infarction and long-term events, the same as was reported by previous studies. 14 So, other therapeutic strategies that can inhibit the inflammatory response are needed to prevent periprocedural myocardial injury.…”

Section: Discussionsupporting

confidence: 82%

Prognostic role of hs-CRP before and after Percutaneous Coronary Intervention in Patients with Stable Angina Pectoris

Das¹,

Zaman²,

Rashid³

et al. 2022

Univ. Heart J.

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Risk Stratification of Patients with Minor Troponin-I Elevation Unassociated with Acute Myocardial Infarction

et al. 2006

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Background and Objectives：Although cardiac troponin I is widely used as a marker for myocardial infarction (MI), minor elevations of cardiac troponin I are also observed in other clinical situations. The prognostic factors for patients with these clinical features are not well established. The aim of this study was to discover the predictors of mortality for the patients who had minor troponin elevations without acute MI. Subjects and Methods：We enrolled consecutive 154 patients from the emergency department or inpatient units who had a peak troponin I level greater than the lower limit of detectability (0.04 ng/mL), and the level was also less than the suggestive value of MI (0.6 ng/mL). They were with chest pain or nonspecific symptoms of circulatory abnormality, but they lacked the traditional features of acute MI. The endpoint was defined as death from all causes. The Cox proportional hazard model was used to test the relationship between the clinical and biochemical variables and the outcomes. Results：During the follow-up period of 7.9±7.3 months, mortality occurred in 15 patients. Age, the creatine kinase myocardial isoform (CK-MB) level and the C-reactive protein (CRP) level as continuous variables had significant correlations with the occurrence of death. After adjusting for any possible confounders in the multivariate model, these variables remained as independent predictors of mortality: age (HR 1.07, CI 1.02-1.14, p=0.012), CK-MB level (HR 1.61, CI 1.16-2.24, p=0.005), and CRP level (HR 1.01, CI 1.00-1.01, p=0.025). Conclusion： Integration of the CK-MB and CRP levels, as well as age, can be used for risk-stratification in the patients showing minor troponin I elevation for reasons other than acute MI. (Korean Circulation J 2006;36:60-65)

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Changes of C-reactive Protein are Associated With Myocardial Injury After Successful Percutaneous Coronary Intervention

Rhee

Yun

et al. 2008

Korean Circ J

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Background and Objectives: Myocardial injury after percutaneous coronary intervention (PCI) occurs frequently and it is associated with an adverse clinical outcome. Mechanical factors have been implicated in this complication and the role of inflammation has not yet been clearly determined. We evaluated the effect of an inflammatory response during PCI on periprocedural myocardial injury. Subjects and Methods: We prospectively studied 231 patients (mean age: 62.8±10.6 years, males: 60.6%) who underwent elective coronary stenting. For the exclusion of mechanical injury to the myocardium, we excluded those patients who developed complications during PCI. Blood samples for measuring the high sensitivity C-reactive protein (hsCRP) and troponin T (TnT) were obtained before the procedure and at 6 hours and 24 hours after PCI. The inflammatory response to PCI was calculated as the difference between the peak postprocedural hsCRP level and the preprocedural hsCRP level (delta CRP). We divided the patients according to the median value of delta CRP: Group I <2.2 mg/dL and Group II ≥2.2 mg/dL. Results: Postprocedural TnT elevation was were observed in 72 (31.2%) patients. The baseline clinical and angiographic characteristics were not difference between the two groups. The incidence of any TnT elevations was higher in the Group II than that in Group I (19.8% vs 42.6%, respectively, p<0.001). The incidences of TnT levels over 3 times the upper normal limit and 5 times the upper normal limit were also higher in Group II than in Group I (11.2% vs 21.7%, respectively, p=0.031, for a TnT level 3 times the upper normal limit, and 6.0% vs 13.9%, respectively, for a TnT level 5 times the upper normal limit). Multivariate analysis revealed that postprocedural hsCRP elevation and complex lesion were the significant independent predictors of postprocedural TnT elevation. Conclusion: Elevated hsCRP levels were associated with a higher risk of postprocedural troponin elevation in patients undergoing uncomplicated PCI. These results emphasized the role of inflammation in the pathogenesis of periprocedural myocardial injury.

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The Effect of Systemic Inflammation on the Elevation of Troponin I after Percutaneous Transluminal Coronary Angioplasty with Stent in Patients with Stable Angina

Cited by 3 publications

References 21 publications

Prognostic role of hs-CRP before and after Percutaneous Coronary Intervention in Patients with Stable Angina Pectoris

Prognostic role of hs-CRP before and after Percutaneous Coronary Intervention in Patients with Stable Angina Pectoris

Risk Stratification of Patients with Minor Troponin-I Elevation Unassociated with Acute Myocardial Infarction

Changes of C-reactive Protein are Associated With Myocardial Injury After Successful Percutaneous Coronary Intervention

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