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Biomarker release after percutaneous coronary intervention in patients without established myocardial infarction as assessed by cardiac magnetic resonance with late gadolinium enhancement
Author(s) -
Vieira de Melo Rodrigo Morel,
Hueb Whady,
Nomura Cesar Higa,
Ribeiro da Silva Expedito Eustáquio,
Villa Alexandre Volney,
Oikawa Fernando Teiichi Costa,
da Costa Leandro Menezes Alves,
Rezende Paulo Cury,
Garzillo Cibele Larrosa,
Lima Eduardo Gomes,
Franchini Ramires Jose Antonio,
Kalil Filho Roberto
Publication year - 2017
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27125
Subject(s) - medicine , conventional pci , percutaneous coronary intervention , cardiology , myocardial infarction , timi , biomarker , cardiac magnetic resonance imaging , troponin , magnetic resonance imaging , creatine kinase , troponin i , radiology , biochemistry , chemistry
Objectives This study aimed to evaluate the amount and pattern of cardiac biomarker release after elective percutaneous coronary intervention (PCI) in patients without evidence of a new myocardial infarction (MI) after the procedure as assessed by cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE). Background The release of myocardial necrosis biomarkers after PCI frequently occurs. However, the correlation between biomarker release and the diagnosis of procedure‐related MI type 4a has been controversial. Methods Patients with normal baseline cardiac biomarkers who were referred for elective PCI were prospectively included. CMR with LGE was performed in all of the patients before and after the intervention. Measurements of troponin I (TnI) and creatine kinase MB fraction (CK‐MB) were systematically performed before and after the procedure. Patients with a new LGE on the post‐procedure CMR were excluded. Results Of the 56 patients with no evidence of a procedure‐related MI as assessed by CMR after the PCI, 48 (85.1%) exhibited an elevation of TnI above the 99th percentile. In 32 patients (57.1%), the peak was greater than five times this limit. Additionally, 17 patients (30.4%) had a CK‐MB peak above the 99th percentile limit, but this peak was greater than five times the 99th percentile in only two patients (3.6%). The median peak release of TnI was 0.290 (0.061–1.09) ng/mL, which was 7.25‐fold higher than the 99th percentile. Conclusions In contrast to CK‐MB, an abnormal release of TnI often occurs after an elective PCI procedure, despite the absence of a new LGE on CMR.