Influence of gender on the prognostic value of troponin I after elective percutaneous coronary interventions.
OBJECTIVE
To evaluate the association between troponin I concentrations (TnI) in patients submitted to elective percutaneous coronary interventions (PCI) and adverse coronary events (ACE) during a six month follow-up period.


METHODS
One hundred and eleven patients who had been submitted to an elective PCI were consecutively selected during a one year timeframe. The patients had stable angina (SA), unstable angina (UA) or silent ischemia (SI) and were asymptomatic for at least 72 hours before the procedure. TnI concentrations were measured between 8 and 24 hours after the PCI. Each patient was contacted by telephone six months later and interviewed regarding ACE which were defined as death, myocardial infarction, new revascularization and recurrent ischemia.


RESULTS
Twenty-four patients showed elevated concentrations of TnI (21.6%) after the PCI regardless of clinical characteristics or procedure complications. Those who presented elevated TnI concentrations had higher event rates: 66.7 vs. 42.5% (RR=1.57; CI 95%=1.08-2.28). This risk seems to be higher in the subgroups of females and patients with a previous diagnosis of unstable angina. Multivariate analysis confirmed that gender was the only effect modifying co-variable associated with ACE risk, which is higher for females with elevated TnI concentrations (OR=7.22; CI 95%=1.4 -36.9) and unaltered for males (OR=1.26; CI 95%=0.35-4.55).


CONCLUSIONS
Elevated TnI concentrations were a common occurrence after PCI and is a factor related to the development of ACE in the mid term. However, when adjusted for other variables, this effect is only maintained in female patients.
Braga
Julio Cesar Vieira
JC
Hospital Português, Salvador, BA. juliobraga@cardiol.br
Bitencourt
Almir Galvão Vieira
AG
Andrade
Marianna Deway
MD
Aras
Roque
R
Esteves
José Péricles
JP
D000368:Aged; D000787:Angina Pectoris / Q000097:blood / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000097:blood / Q000209:etiology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012737:Sex Factors; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I