Role of cardiac troponin T in the long-term risk stratification of patients undergoing percutaneous coronary intervention

Kizer, Jorge R.; Muttrej, Manoj R.; Matthai, William H.; McConnell, Joseph P.; Nardone, Heather C.; Sonel, Ali F.; Keane, Martin; Wilensky, Robert L.

doi:10.1016/s0195-668x(03)00258-6

Cited by 86 publications

(60 citation statements)

References 31 publications

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“…[5][6][7]9 A postprocedure increase in cTnI concentration of Ͼ5-fold baseline levels is an independent predictor of a composite of death, MI, and revascularization at 1 year (hazard ratio, 2.39; 95% CI, 1.09 to 5.26). 7 Gadolinium late enhancement with cardiac magnetic resonance has demonstrated that procedural cTnI release is due to MI both downstream of the stented lesion and adjacent to the implanted stent. 3,25 Microembolization of plaque debris and side-branch occlusion have been proposed as the most likely mechanisms of cTnI release.…”

Section: Discussionmentioning

confidence: 99%

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Cardiac Remote Ischemic Preconditioning in Coronary Stenting (CRISP Stent) Study

et al. 2009

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Background-Myocyte necrosis as a result of elective percutaneous coronary intervention (PCI) occurs in approximately one third of cases and is associated with subsequent cardiovascular events. This study assessed the ability of remote ischemic preconditioning (IPC) to attenuate cardiac troponin I (cTnI) release after elective PCI. Methods and Results-Two hundred forty-two consecutive patients undergoing elective PCI with undetectable preprocedural cTnI were recruited. Subjects were randomized to receive remote IPC (induced by three 5-minute inflations of a blood pressure cuff to 200 mm Hg around the upper arm, followed by 5-minute intervals of reperfusion) or control (an uninflated cuff around the arm) before arrival in the catheter laboratory. The primary outcome was cTnI at 24 hours after PCI. Secondary outcomes included renal dysfunction and major adverse cardiac and cerebral event rate at 6 months. The median cTnI at 24 hours after PCI was lower in the remote IPC compared with the control group (0.06 versus 0.16 ng/mL; Pϭ0.040). After remote IPC, cTnI was Ͻ0.04 ng/mL in 44 patients (42%) compared with 24 in the control group (24%; Pϭ0.01). Subjects who received remote IPC experienced less chest discomfort (Pϭ0.0006) and ECG ST-segment deviation (Pϭ0.005) than control subjects. At 6 months, the major adverse cardiac and cerebral event rate was lower in the remote IPC group (4 versus 13 events; Pϭ0.018). Conclusion-Remote IPC reduces ischemic chest discomfort during PCI, attenuates procedure-related cTnI release, and appears to reduce subsequent cardiovascular events. (Circulation. 2009;119:820-827.)

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Section: Discussionmentioning

confidence: 99%

“…[2][3][4] A number of studies have demonstrated that procedure-related troponin release is associated with subsequent cardiovascular events. [5][6][7][8][9] …”

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confidence: 99%

Cardiac Remote Ischemic Preconditioning in Coronary Stenting (CRISP Stent) Study

et al. 2009

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“…13 It has also been demonstrated that elevation of troponin T is relatively common among patients with stable CAD undergoing PCI and is an independent prognostic indicator of ischemic complications. 4,5 Prasad et al found that an isolated minor elevation in troponin T after PCI without a rise in CK-MB following PCI provided long-term prognostic information regarding mortality and MI. 6 Several reports have shown that an increase in cardiac troponin T can be found in a proportion of patients after PCI ranging from less than 10% to almost 50%.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 It has also been reported that elevation of troponin T is relatively common among patients with stable coronary artery disease undergoing PCI and is an independent prognostic indicator of ischemic complications. 4,5 However, there were few studies about comprehensive risk factor analysis of troponin T elevation in patients with stable CAD after drug-eluting stent (DES) implantation. Therefore, we designed this clinical study to chronic inflammation; (7) dysfunction of hematological and immunological system; or (8) carcinoma or a condition treated with immunosuppressive agents.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors of Cardiac Troponin T Elevation in Patients with Stable Coronary Artery Disease After Elective Coronary Drug‐Eluting Stent Implantation

Chen

Qian

et al. 2011

Clinical Cardiology

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Background: Cardiac troponin T elevation after coronary intervention has been demonstrated to be associated with the prognosis of coronary artery disease (CAD). However, there were few studies about comprehensive risk factors analysis of troponin T elevation after elective drug-eluting stent (DES) implantation. Hypothesis: The prognosis of CAD after coronary interventions was associated with clinical and procedural risk factors of CAD, such as age, hypertension, severity extent of CAD and so on. Methods: From March to December in 2010, patients with stable CAD were admitted for elective coronary intervention in our hospital. They were divided into an elevated troponin T group and a normal troponin T group by postprocedural troponin T. Clinical factors, laboratory-test factors, and angiographic factors (such as gender, age, cholesterol, Gensini score, and others) were analyzed. Results: A total of 209 patients with an average age of 64.0 ± 9.9 years were enrolled in the study: 70 patients with elevated troponin T (≥0.03 ng/mL) after DES implantation and 139 patients with normal troponin T (<0.03 ng/mL). After univariate analysis, we found that age, hypertension, total cholesterol, low density lipoprotein-cholesterol (LDL-C), Gensini score, number of stenosed vessels, and total implanted stents were associated with postprocedural troponin T elevation. According to the results of multivariate analysis, we found that age, total cholesterol, number of stenosed vessels, and number of implanted stents were independent risk factors of postprocedural troponin T elevation. Conclusions: Age, serum total cholesterol, number of stenosed vessels, and number of implanted stents could be independent risk factors of troponin T elevation after elective DES implantation.

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“…cTn release after PCI ranges in incidence from 14% to 48% (77)(78)(79)(80)(81)(82). This wide variation is caused by the assay and corresponding cutoff concentrations used, as well as the underlying indication for the revascularization procedure (e.g., acute vs elective) and the type of procedure performed.…”

Section: Biomarkers After Pcimentioning

confidence: 99%

National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Use of Cardiac Troponin and B-Type Natriuretic Peptide or N-Terminal proB-Type Natriuretic Peptide for Etiologies Other than Acute Coronary Syndromes and Heart Failure

et al. 2007

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Role of cardiac troponin T in the long-term risk stratification of patients undergoing percutaneous coronary intervention

Cited by 86 publications

References 31 publications

Cardiac Remote Ischemic Preconditioning in Coronary Stenting (CRISP Stent) Study

Cardiac Remote Ischemic Preconditioning in Coronary Stenting (CRISP Stent) Study

Risk Factors of Cardiac Troponin T Elevation in Patients with Stable Coronary Artery Disease After Elective Coronary Drug‐Eluting Stent Implantation

National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Use of Cardiac Troponin and B-Type Natriuretic Peptide or N-Terminal proB-Type Natriuretic Peptide for Etiologies Other than Acute Coronary Syndromes and Heart Failure

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