Relationship of serum cardiac markers following successful percutaneous coronary intervention and subsequent exercise capacity in patients with chronic stable angina: a pilot study.
We performed a pilot study to assess the significance of modest, asymptomatic, elevated serum cardiac markers--troponin T (TnT) and creatinine kinase-MB (CK-MB)--18-24 h following successful elective percutaneous coronary intervention (PCI) and to explore their relationship with changes in aerobic exercise capacity, as measured by peak oxygen consumption (VO2), 6 weeks following the procedure. Twenty-three patients with single-vessel disease and chronic angina performed an incremental cardiopulmonary exercise test before and 6 weeks after successful uncomplicated PCI. A venous blood sample was taken at rest before PCI and 18-24 h after the procedure. Successful PCI resulted in a trend towards an increased peak VO2 [21.62 +/- 0.64 (pre) vs. 23.03 +/- 0.75 ml/ kg/min (post), p = 0.07; mean +/- SEM]. There was a significant increase [median (IQR)] in TnT, from 0.00 (0.00) microg/l at baseline increasing to 0.02 (0.03) microg/l at 18-24 h, p = 0.002. CK-MB levels showed no significant difference. In the group of 15/23 (65%) patients with an elevation in serum TnT (>/=0.01 microg/l), 18-24 h after successful PCI, there was no significant increase in peak VO2 [23.31 +/- 0.96 (pre) vs. 23.89 +/- 1.09 ml/kg/min (post), p = 0.57]. In 8 (35%) patients with no rise in TnT at 18-24 h, a significant increase in peak VO2 was observed following successful PCI [23.10 +/- 0.91 (pre) vs. 25.09 +/- 0.75 ml/kg/min (post), p = 0.02]. Although 7 of these 8 patients increased their peak VO2, the absence of a TnT rise at 18-24 h was not significantly associated with an increase in peak VO2 following successful PCI (p = 0.18). To confirm these interesting initial results and investigate the relationship of serum cardiac markers following successful PCI and subsequent exercise capacity, further studies are required.
Williams
Simon G
SG
Cardiothoracic Centre, Liverpool, UK. drsgwilliams@hotmail.com
Stables
Rod H
RH
Wright
David J
DJ
Taylor
Steve
S
Thompson
Douglas
D
Tan
Lip-Bun
LB
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood
D015415:Biomarkers; D020107:Troponin T; D003402:Creatine Kinase