Incidence, predictors, and clinical significance of troponin-I elevation without creatine kinase elevation following percutaneous coronary interventions

Prognostic implications of C-reactive protein and troponin following percutaneous coronary intervention

“…Several smaller studies (7,13,26) have demonstrated a relationship between troponin rise and both acute and long-term outcomes. Recently, several large studies (1,15,27) have demonstrated results similar to ours. Elevations of troponins up to five times the normal level were not associated with enhanced risk in these studies.…”

“…A rise in troponin is associated with impairment of microvascular perfusion (3) and necrosis documented by cardiac magnetic resonance imaging (4). The factors leading to myocardial necrosis have included complex lesions, complications at the time of the procedure such as dissection or side branch occlusion, and left ventricular dysfunction (15). In the present study, we extended these observations in a large prospectively collected cohort of subjects without complications at the time of the procedure, and without significant CK rise.…”

“…Several studies demonstrated an adverse effect of troponin elevation on post-PCI cardiovascular events (7,13,14). However, more recent data do not support this (1,15). Therefore, the role of troponin as a prognostic marker following PCI is not clear.…”

Frequency, Risk Factors, and Effect on Long‐Term Survival of Increased Troponin I Following Uncomplicated Elective Percutaneous Coronary Intervention

“…In their study an elevated cTnI was defined as either >2.0 ng/ml or a >20% rise from elevated pre-PCI values. Natarajan et al 9 reported cTnI above the upper normal value in 17% of 1,128 post-PCI patients after exclusion of patients with abnormal pre-PCI cTnI values or elevated pre-PCI or post-PCI creatine kinase values. Kini and colleagues 3 reported elevated cTnI (defined as equal to or greater than 2 ng/ml) in 39% of 2,873 post-PCI patients after excluding patients with cardiogenic shock or pre-PCI increases of CK-MB.…”

“…These include multivessel or multilesion PCI, lesion length and complexity, presence of thrombus, rest angina, PCI of SVGs, use of multiple stents, older age, increased fluoroscopy time, and increased use of contrast media. 3,8,9,11 In a study of 2,256 patients undergoing PCI with intravascular ultrasound imaging, Mehran et al 12 found plaque burden to be a significant independent predictor of post-PCI CK-MB elevation.…”