title: [Mechanism of troponin and CK-MB release after percutaneous coronary interventions].
abstract: Cardiac troponins are highly sensitive and specific markers of early detection of myocardial injury. The incidence of cardiac troponin increase is of 5-40% after percutaneous coronary interventions and is significantly higher in patients undergoing stenting than in patients with balloon angioplasty only. Four mechanisms are responsible for myocardial necrosis during coronary angioplasty: 1) distal embolization of small fragments of the atherosclerotic plaque; 2) side branch occlusion; 3) intimal dissection, and 4) temporary vessel occlusion. The multiple and/or complex lesions, the diabetic status and plaque instability increase the probability of troponin elevation during coronary angioplasty. Moreover, the long time needed for interventional as well as atherectomy procedures may induce myocardial necrosis. In conclusion, after successful percutaneous coronary interventions, minor elevation of troponin may occur. In this setting cardiac troponin I is a highly specific marker of myocardial injury.
authors.affiliation: U.O. di Cardiologia Interventistica, Università degli Studi Magna Graecia, Catanzaro. indolfi@unicz.it
authors.forename: Annalisa
authors.initials: A
authors.lastname: Mongiardo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ferraro
authors.forename: Roberto
authors.initials: R
authors.lastname: Ceravolo
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Mascaro
authors.forename: Antonio
authors.initials: A
authors.lastname: Curcio
authors.forename: Esther
authors.initials: E
authors.lastname: Campopiano
authors.forename: Ciro
authors.initials: C
authors.lastname: Indolfi
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D015415:Biomarkers; D003324:Coronary Artery Disease / Q000150:complications / Q000628:therapy; D003327:Coronary Disease / Q000209:etiology; D003402:Creatine Kinase / Q000378:metabolism*; D052279:Creatine Kinase, MB Form; D004617:Embolism / Q000209:etiology; D006801:Humans; D007527:Isoenzymes / Q000378:metabolism*; D008833:Microcirculation; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism*; D009206:Myocardium / Q000473:pathology; D009336:Necrosis; D012680:Sensitivity and Specificity; D015607:Stents / Q000009:adverse effects*; D019210:Troponin I / Q000378:metabolism*; D017539:Tunica Intima / Q000293:injuries
chemical_list: D015415:Biomarkers; D007527:Isoenzymes; D019210:Troponin I; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form