Occurrence of Non‐Q wave Myocardial Infarction Following Percutaneous Coronary Intervention in the Stent Era: Systematic Monitoring of the Three Markers of Myocardial Necrosis

Abstract

The elevation of at least one biochemical marker of myocardial necrosis is frequent following successful PCI with routine stent implantation. CK-MB mass is the most practical marker, having optimal kinetic and peaking with the first 12-18 hours post-PCI. Definitive data on the prognostic role and the applicability for the diagnosis of myocardial infarction of minor elevation of CK-MB mass or isolated increase of TnI are lacking.

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

“…The primary endpoint in our meta-analysis was not specifically reported in four studies [20,22,30,31]. In one older study with a very small sample size of 23 patients, an unusually high cut-off value for troponin T was used, and therefore this study was excluded [32].…”

Intracoronary ST-Segment Shift Soon After Elective Percutaneous Coronary Intervention Accurately Predicts Periprocedural Myocardial Injury

“…12 Abnormal postprocedural troponin elevations have been documented in at least 50% of patients undergoing PCI. 5,13 In a recent prospective multicenter cohort study that included 3494 consecutive patients undergoing PCI, abnormal postprocedural CK-MB and cTnI values were found in 16% and 44% of patients, respectively. 14 In our population of stable patients undergoing elective single-vessel PCI, the rates of abnormal CK-MB and cTnI elevation after intervention (10% and 46% of cases, respectively) were similar to those reported by others.…”

“…14 In our population of stable patients undergoing elective single-vessel PCI, the rates of abnormal CK-MB and cTnI elevation after intervention (10% and 46% of cases, respectively) were similar to those reported by others. 13,14 A recent meta-analysis of 23 230 patients undergoing PCI in 7 large prospective trials showed that long-term mortality risk increases at any level above normal postprocedural CK-MB, 15 although in most studies postprocedural elevation of CK-MB, but not of cTnI, has been found to influence long-term mortality. 14,16 However, even mild cTnI elevation after PCI has been shown to be associated with discrete microinfarction findings on contrast-enhanced MRI studies.…”

Effects of persistent platelet reactivity despite aspirin therapy on cardiac troponin I and creatine kinase-MB levels after elective percutaneous coronary interventions

“…Previous studies have reported in 5.5-15% of patients had CK-MB elevation 3 times the upper limit of normal, 2.5-3% of patients had CK-MB elevation 5 times the upper limit of normal, and 35-50% of patients had cardiac troponins elevation above the upper limit of normal after PCI [28,33]. Chen and colleagues reported 37.9% of aspirin resistant patients had CK-MB elevation 1-3 times the upper limit of normal and 10.3% of aspirin resistant patients had CK-MB elevation 3-5 times the upper limit of normal.…”