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

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

Research output: Contribution to journalArticlepeer-review

87 Scopus citations

Abstract

Aims To investigate the long-term prognostic significance of pre- and post-procedure troponin T (TnT) elevations in patients undergoing percutaneous coronary intervention (PCI). Methods and results TnT and CK-MB were measured pre- and post-procedure in 212 patients undergoing PCI. Major adverse events (composite of death, myocardial infarction and revascularization) were ascertained 6 years later. Pre-procedural TnT was a significant independent predictor of time to major events (hazard ratio [HR] 1.75, 95% confidence interval [CI] 1.16-2.64) and death or myocardial infarction. Post-procedural TnT elevation above normal was the only independent predictor of the primary end-point at 1 year (HR 2.39, 95% CI 1.09-5.26) but was not significantly related to event-free survival throughout follow-up. Post-PCI elevation of TnT 5× above normal, however, did significantly predict time to events during the entirety of follow-up. By contrast, CK-MB was not an independent predictor in any of the analyses. Conclusions Our study confirms the long-term prognostic value of pre-procedural TnT elevation in patients undergoing PCI, and demonstrates the superior predictive ability of a post-procedural increase in TnT 5× normal for long-term adverse events. Whether the prognostic significance of smaller post-procedural TnT elevations extends beyond the intermediate-term awaits further investigation.

Original languageEnglish (US)
Pages (from-to)1314-1322
Number of pages9
JournalEuropean heart journal
Volume24
Issue number14
DOIs
StatePublished - Jul 2003

Keywords

  • Angioplasty
  • Creatine kinase
  • Myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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