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

Hubáček, J.; Basran, Rashpal; Shrive, Fiona M.; Shewchuk, Lana; Goodhart, David; Anderson, Todd J.

doi:10.1016/s0828-282x(09)70483-0

Cited by 19 publications

(14 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Влияние повреждения миокарда во время планового ЧКВ на прогноз у больных стабильной ИБС на протяжении многих лет является предметом активного обсуждения. При этом часть авторов считает прогностически неблагоприятным любое повышение уровня Tn I в результате вмешательства [9, 23,24,25], другими же приводятся доказательства отсутствия связи с прогнозом даже при развитии периоперационного инфаркта миокарда [26,27,28]. Неоднозначность оценки повышения Tn I как самостоятельного фактора риска в различных исследованиях может быть связана с целым рядом причин: разнородностью обследованных больных ИБС (стабильная и нестабильная стенокардия, острый коронарный синдром, инфаркт миокарда), выраженностью ишемии миокарда, характером поражения коронарного русла и особенностями проведения процедуры ЧКВ, наличием или отсутствием сердечной недостаточности, нарушения функции почек, пороговым уровнем Tn I, особенностями статистического анализа.…”

Section: Discussionunclassified

Risk Assessment of Cardiac Events in Patients with Stable Ischemic Heart Disease After Percutaneous Coronary Intervention, Accompanied by Myocardial Damage

Воробьева

Бондаренко

Bart

et al. 2019

Transl. med. (Print)

View full text Add to dashboard Cite

Background. Percutaneous coronary intervention (PCI) in patients with ischemic heart disease (IHD) is followed often by myocardial injury. Up to now there is no mutual agreement to the inﬂ uence of the perioperative myocardial injury on the long-term prognosis of the IHD patients.Objective. The aim of study was to assess the risk factors for the development of cardiac events in the long-term period in patients with stable coronary artery disease with myocardial damage after PCI.Materials and methods. The study included 113 patients with stable coronary artery disease who underwent planned PCI. Serum troponin levels were determined before and 24 hours after the intervention. Re-examination of patients was carried out after 12–18 months (average 15 months).Results. The post PCI Tn I level over a reference one was registered in 25 patients (22,2 %). During the follow-up period the cardiovascular events took place in 25,6 % patients: acute myocardial infarction (MI) in 3 (2,6 %), angina occurred in 23 %. One-way ANOVA revealed a signiﬁ cant value for cardiac risk events of the patient age, number of stenosed arteries, summary degree of stenosis, and their complicity, number of implanted stents. The ﬁ rst three of them were included in the ﬁ nal combination of the stepwise discriminant analysis. The general linear model of the latter detected additionally statistical signiﬁ cance of the variables “MI in the past” (before PCI) and “number of postdilatations“.Conclusion. In patients with stable ischemic heart disease, included in the study, the determining risk factors for the development of cardiac events were the prevalence and nature of the obstructive lesion of the coronary bed, age, previous myocardial infarction, and especially the performance of PCI. Myocardial damage was not identiﬁ ed as a risk factor for recurrent angina or myocardial infarction.

show abstract

Section: Discussionunclassified

Risk Assessment of Cardiac Events in Patients with Stable Ischemic Heart Disease After Percutaneous Coronary Intervention, Accompanied by Myocardial Damage

Воробьева

Бондаренко

Bart

et al. 2019

Transl. med. (Print)

View full text Add to dashboard Cite

show abstract

“…Among factors affecting baseline risk, systemic inflammatory status as assessed by baseline levels of CRP, has been associated with more periprocedural complications after PCI . Six previous studies have evaluated the association of baseline CRP both with cardiac troponin and CK‐MB rise . Of these studies, five have been performed with troponin I or T as a biomarker of myocardial injury, whereas only one study assessed CK‐MB release .…”

Section: Discussionmentioning

confidence: 99%

“…Six previous studies have evaluated the association of baseline CRP both with cardiac troponin and CK‐MB rise . Of these studies, five have been performed with troponin I or T as a biomarker of myocardial injury, whereas only one study assessed CK‐MB release . However, given the complex anatomy of coronary bifurcations, data obtained in other studies could not been readily transferred to this specific type of lesions.…”

Section: Discussionmentioning

confidence: 99%

“…However, given the complex anatomy of coronary bifurcations, data obtained in other studies could not been readily transferred to this specific type of lesions. Moreover, studies that assessed cardiac troponin provided conflicting results with only three of five studies that assessed cardiac troponin showing a positive correlation between CRP and periprocedural myocardial infarction . Of interest, a graded association between CRP levels and the extent of myocardial necrosis was observed in some studies .…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, studies that assessed cardiac troponin provided conflicting results with only three of five studies that assessed cardiac troponin showing a positive correlation between CRP and periprocedural myocardial infarction . Of interest, a graded association between CRP levels and the extent of myocardial necrosis was observed in some studies . In the GENERATION study, authors evaluated the association between CRP levels and CK‐MB release in patients undergoing bare metal stenting for the treatment of chronic stable angina, non–ST‐segment elevation myocardial infarction, or ST‐segment elevation myocardial infarction .…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Association of baseline C‐reactive protein levels with periprocedural myocardial injury in patients undergoing percutaneous bifurcation intervention: A CACTUS study subanalysis

Niccoli

Sgueglia

Latib

et al. 2013

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

Consideration of a new definition of clinically relevant myocardial infarction after coronary revascularization: An expert consensus document from the society for cardiovascular angiography and interventions (SCAI)

Moussa

Klein

Shah

et al. 2013

Cathet Cardio Intervent

211

255

View full text Add to dashboard Cite

Numerous definitions have been proposed for the diagnosis of myocardial infarction (MI) after coronary revascularization. The universal definition for MI designates post procedural biomarker thresholds for defining percutaneous coronary intervention (PCI)-related MI (type 4a) and coronary artery bypass grafting (CABG)-related MI (type 5) which are of uncertain prognostic importance. In addition, for both MI types cTn is recommended as the biomarker of choice, the prognostic significance of which is less well validated than CK-MB. Widespread adoption of a MI definition not clearly linked to subsequent adverse events such as mortality or heart failure may have serious consequences for the appropriate assessment of devices and therapies, may affect clinical care pathways, and may result in misinterpretation of physician competence. Rather than employing an MI definition sensitive for small degrees of myonecrosis (the occurrence of which, based on contemporary large-scale studies, are unlikely to have important clinical consequences), it is instead recommended that a threshold level of biomarker elevation which has been strongly linked to subsequent adverse events in clinical studies be used to define a "clinically relevant MI." The present document Catheterization and Cardiovascular Interventions 83: 27-36 (2014) introduces a new definition for "clinically relevant MI" after coronary revascularization (PCI or CABG) which is applicable for use in clinical trials, patient care, and quality outcomes assessment. V C 2013 Wiley Periodicals, Inc.

show abstract

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

Cited by 19 publications

References 30 publications

Risk Assessment of Cardiac Events in Patients with Stable Ischemic Heart Disease After Percutaneous Coronary Intervention, Accompanied by Myocardial Damage

Risk Assessment of Cardiac Events in Patients with Stable Ischemic Heart Disease After Percutaneous Coronary Intervention, Accompanied by Myocardial Damage

Association of baseline C‐reactive protein levels with periprocedural myocardial injury in patients undergoing percutaneous bifurcation intervention: A CACTUS study subanalysis

Consideration of a new definition of clinically relevant myocardial infarction after coronary revascularization: An expert consensus document from the society for cardiovascular angiography and interventions (SCAI)

Contact Info

Product

Resources

About