Troponin T, troponin I and creatine kinase-MB mass after elective coronary stenting

Vecchia, Luigi La; Bedogni, Francesco; Finocchi, G; Mezzena, G; Martini, Manuela; Sartori, M; Castellani, A.; Soffiati, Guiliano; Vincenzi, M. De

doi:10.1097/00019501-199607000-00008

Cited by 44 publications

(22 citation statements)

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“…On the other hand, the troponins I and T, considered a pattern for detecting myonecrosis, had a similar behavior, with 20 and 23% elevations in the second sample after stent implantation. Researchers have reported that the elevation of these 3 markers after intervention ranges from 20 to 40% [10][11][12] , usually exceeding the percentages of the cardiac enzymes, particularly the CK-MB activity, in concordance with our findings. We also observed that all 4 markers had increased more frequently in the second sample after the procedure.…”

Section: Incidence Of Intracardiac Thrombus and Thromboembolism In Thsupporting

confidence: 92%

Avaliação comparativa do valor prognóstico de quatro marcadores bioquímicos de lesão miocárdica pós intervenções percutâneas utilizando stents coronarianos

Centemero¹,

Sousa²,

Staico³

et al. 2004

Arq. Bras. Cardiol.

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The systematic assessment of total creatine kinase (total CK) and its MB subfraction (CK-MB) after percutaneous coronary intervention shows that 5% to 40% of the patients successfully treated have an elevation in the serum level of those enzymes, which may represent a certain degree of myocardial necrosis [1][2][3] . Recently, the analysis of other very sensitive biochemical markers specific for identifying myocardial damage (CK-MB mass, troponins T and I) has intensified the detection of that phenomenon, which has been much more frequently observed with the implantation of coronary stents 4,5 .This study aimed at establishing the clinical meaning of those alterations and their impact on the occurrence of adverse cardiac events. It also had the following objectives: 1) to assess the incidence of the elevations in the CK-MB activity and mass and in the levels of troponins T and I after elective coronary stenting; 2) to analyze the association between the elevation of the markers and clinical, angiographic, and technical variables, and periprocedure problems; 3) to determine the prognostic effect of the elevation of the 4 markers after intervention on the occurrence of death, myocardial infarction, and need for new revascularization procedures in a one-year period. MethodsThis prospective study comprised 199 consecutive patients from the coronary angioplasty unit at the Instituto Dante Pazzanese de Cardiologia. They underwent elective coronary stent implantation for the treatment of stenoses located in native coronary arteries from August 2001 to January 2002. The patients met the following inclusion criteria: both genders; no restriction regarding age; normal levels of CK-MB activity in the 24 hours preceding the intervention; patients with clinically controlled stable or unstable angina (no recurrence of pain in the 2 weeks preceding the percutaneous treatment, to reduce the chances of an elevation in the troponins before the procedure); asymptomatic patients with ischemia detected on functional tests; presence of luminal obstruction > 50% in one or more vessels, with primary lesions anatomically favorable to stent implantation; absence of severe left ventricular dysfunction (EF > 0.30); elective treatment with angiographic success at the end of the procedure.The exclusion criteria were as follows: renal failure (creatinine > 2.0 mg/dL); presence of comorbidities that could affect late ResultsChanges in the levels of the 4 markers after stent implantation are relatively frequent (6.1% to 32.8%) ConclusionSystematic monitoring of CK-MB activity after coronary stenting is justified due to its clinical and laboratory behavior reported in studies relating its elevation after the procedure to a worse late outcome, and due to its low cost.

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Section: Incidence Of Intracardiac Thrombus and Thromboembolism In Thsupporting

confidence: 92%

Avaliação comparativa do valor prognóstico de quatro marcadores bioquímicos de lesão miocárdica pós intervenções percutâneas utilizando stents coronarianos

Centemero¹,

Sousa²,

Staico³

et al. 2004

Arq. Bras. Cardiol.

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“…Karim et al15) reported that the incidence of TnT elevation was 44% in their patients who underwent successful coronary angioplasty in association with side branch occlusion. In contrast, La Vecchia et al 10) have reported that the serum TnT level was elevated in most, but not all, of their patients with side branch occlusion treated with coronary stenting. Genser et al 18) reported that all of their patients treated with balloon angioplasty with TnT elevation showed side branch occlusion or major complications.…”

Section: Discussionmentioning

confidence: 83%

Low Incidence of Minor Myocardial Damage Associated with Coronary Stenting Detected by Serum Troponin T Comparable to That with Balloon Coronary Angioplasty.

et al. 1998

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“…It is diagnosed when an increase of a marker of cardiac necrosis is observed and remains a frequent complication of PCI, occurring in between 5% and 44% of the procedures. 2,3 Of note, even a small post-PCI biomarker increase is significantly associated with an adverse short-and long-term outcome. 4 Previous studies have used intravascular ultrasound (IVUS) to identify atheroma features associated with type IVa MI, showing both plaque burden 5,6 and necrotic core 7,8 as strong risk factors.…”

Section: P Eriprocedural Myocardial Infarction (Type Ivamentioning

confidence: 99%

Predictors of Periprocedural (Type IVa) Myocardial Infarction, as Assessed by Frequency-Domain Optical Coherence Tomography

Porto

Vito

Burzotta

et al. 2012

Circ: Cardiovascular Interventions

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Background-Frequency-domain optical coherence tomography (FD-OCT) is easily able to define both pre-and post-stenting features of the atherosclerotic plaque that can potentially be related to periprocedural complications. We sought to examine which FD-OCT-defined characteristics, assessed both before and after stent deployment, predicted periprocedural (type IVa) myocardial infarction (MI). Methods and Results-FD-OCT was performed before and after coronary stenting in 50 patients undergoing percutaneous coronary intervention (PCI) for either non-ST segment elevation MI (NSTEMI) or stable angina. All patients underwent single-vessel stenting, and only drug-eluting stents were implanted. Troponin T was analyzed on admission, before PCI, and at 12 and 24 hours after PCI, and type IVa MI was defined in stable angina as a rise of at least 3ϫ upper reference limit and in NSTEMI as a pre-PCI troponin T fall, followed by post-PCI troponin T rise Ͼ20%.

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Troponin T, troponin I and creatine kinase-MB mass after elective coronary stenting

Cited by 44 publications

References 0 publications

Avaliação comparativa do valor prognóstico de quatro marcadores bioquímicos de lesão miocárdica pós intervenções percutâneas utilizando stents coronarianos

Avaliação comparativa do valor prognóstico de quatro marcadores bioquímicos de lesão miocárdica pós intervenções percutâneas utilizando stents coronarianos

Low Incidence of Minor Myocardial Damage Associated with Coronary Stenting Detected by Serum Troponin T Comparable to That with Balloon Coronary Angioplasty.

Predictors of Periprocedural (Type IVa) Myocardial Infarction, as Assessed by Frequency-Domain Optical Coherence Tomography

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