Role of cardiac troponin testing in percutaneous transluminal coronary angioplasty.
Percutaneous transluminal coronary angioplasty (PTCA) is a common invasive procedure for myocardial revascularization. This article reviews the role of monitoring cardiac troponins in identifying procedural myocardial damage as a result of PTCA, its associations with balloon inflation time, stenting, side-branch occlusion and the prognostic implications of elevated levels of cardiac troponins. A review of several studies demonstrates that cardiac troponins are more sensitive than creatine kinase MB, CK-MB (mass) in detecting minor myocardial damage during PTCA. Increases in post-procedural cardiac troponin T and cardiac troponin I are associated with a greater degree of morbidity and mortality. Increases are more common and more pronounced following a longer duration of balloon inflation time, stenting and side-branch occlusion. Elevated cardiac troponins pre-procedure are a poor prognostic indicator.
Davis
G K
GK
Clinical Laboratories, Eric Williams Medical Sciences Complex, The University of the West Indies, Champs Fleur, Trinidad. gershwindavis@yahoo.com
D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000175:diagnosis / Q000378:metabolism* / Q000628:therapy*; D006801:Humans; D009206:Myocardium / Q000378:metabolism*; D011237:Predictive Value of Tests; D011379:Prognosis; D019210:Troponin I / Q000378:metabolism; D020107:Troponin T / Q000378:metabolism*
D019210:Troponin I; D020107:Troponin T