Open AccessSensitivity and long‐term prognostic value of cardiac troponin‐i increase shortly after percutaneous transluminal coronary angioplasty
Author(s) -
Attali P.,
Aleil B.,
Depoli F.,
Mossard J. M.,
Wiesel M. L.,
Petitpas G.,
Wuillermin A.,
Cazenave J. P.
Publication year - 1998
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960210511
Subject(s) - medicine , cardiology , creatine kinase , angioplasty , population , troponin i , percutaneous transluminal coronary angioplasty , troponin , myocardial infarction , environmental health
Background : After successful coronary interventions, minor elevations of creatine kinase MB (CK‐MB) identified a population with a worse long‐term prognosis than that in patients without enzyme elevations. In that setting, cardiac troponin‐I (cTn‐I), a highly specific marker for myocardial injury, was considered for a small study; the results did not support the view that significant myocardial damage occurred during successful percutaneous transluminal coronary angioplasty (PTCA). Hypothesis : The present study was designed to assess the rate of elevated values of cTn‐I after successful PTCA and to determine its prognostic value. Methods : CTn‐I and CK‐MB were measured in 44 patients before and daily for 3 days after PTCA. Two groups of patients were considered according to the presence or absence of elevated levels of cTn‐I. The rate of free‐event survival was estimated for the two groups using the Kaplan‐Meier method and was compared with the log rank test. Results : Globally, 36% of patients had an increase in cTn‐I (normal values 0.35 ng/ml) and 9% had an increase in CK‐MB, p = 0.002. The mean time to maximal enzyme level was 1.8 days for cTn‐I and 2.2 days for CK‐MB. Over a follow‐up of 1375 ± 416 days, 18% of patients experienced adverse events, and cTn‐I did not identify a population of worse longterm prognosis. Conclusion : These results suggest that cTn‐I is more sensitive than CK‐MB in identifying minor myocardial damage after PTCA, but these elevated concentrations of cTn‐I in the short‐term aftermath of angioplasty do not seem to be a marker of worse long‐term prognosis.