title: Troponin I elevation and cardiac events after percutaneous coronary intervention.
abstract: BACKGROUND
  Serum troponins are sensitive markers of myonecrosis and ischemia and are now widely used in clinical practice. Although percutaneous coronary intervention (PCI)-related creatine kinase-myocardial band isoenzyme (CK-MB) elevation has been associated with future cardiac events, the significance of troponin elevation in this setting is unknown. We sought to determine whether serum troponin I (Tn-I) elevation after PCI is associated with future cardiac events. Methods and Results Consecutive patients undergoing elective PCI underwent systematic postprocedure measurement of Tn-I and CK-MB levels. Serum levels were correlated with demographic, angiographic, and procedural characteristics and the development of major adverse cardiac events (MACE; defined as death, MI, or need for PCI or coronary bypass graft surgery) at 30 days, 6 months, and 1 year. In 286 consecutive procedures, postintervention myonecrosis-specific Tn-I was elevated in 13.6% of patients, and CK-MB was elevated in 12.9% of patients. Multivariable predictors of Tn-I elevation were procedural side branch occlusion and thrombus formation. Peak Tn-I and CK-MB values were well correlated (r = 0.81, P <.0001). Three-fold elevation of Tn-I after successful PCI was independently predictive of MACE (P =.01).
  
  
  CONCLUSIONS
  Tn-I elevation after elective PCI is relatively common and is associated with procedural complications such as incidental side branch occlusion and thrombus formation. In addition, this study demonstrates that a 3-fold elevation of Tn-I after successful elective PCI is predictive of future cardiac events, especially the need for early repeat revascularization.
authors.affiliation: Division of Cardiology, Northwestern Memorial Hospital and Northwestern University Medical School, Chicago, Ill 60611, USA.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Ricciardi
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Davidson
authors.forename: George
authors.initials: G
authors.lastname: Gubernikoff
authors.forename: Nirat
authors.initials: N
authors.lastname: Beohar
authors.forename: Lorene J
authors.initials: LJ
authors.lastname: Eckman
authors.forename: Michele A
authors.initials: MA
authors.lastname: Parker
authors.forename: Robert O
authors.initials: RO
authors.lastname: Bonow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000097:blood / Q000175:diagnosis; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000097:blood / Q000601:surgery / Q000628:therapy*; D003402:Creatine Kinase / Q000097:blood*; D052279:Creatine Kinase, MB Form; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis*; D017202:Myocardial Ischemia / Q000097:blood / Q000175:diagnosis; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D007527:Isoenzymes; D020107:Troponin T; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form