Sensitivity and long-term prognostic value of cardiac troponin-I increase shortly after percutaneous transluminal coronary angioplasty.
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).


OBJECTIVE
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 long-term prognosis.


CONCLUSIONS
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.
Attali
P
P
Service de Cardiologie, Hôpitaux Universitaires de Strasbourg, France.
Aleil
B
B
Petitpas
G
G
DePoli
F
F
Wiesel
M L
ML
Wuillermin
A
A
Cazenave
J P
JP
Mossard
J M
JM
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003327:Coronary Disease / Q000097:blood / Q000628:therapy*; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I; D003402:Creatine Kinase