Prognostic value of troponin after elective percutaneous coronary intervention: A meta-analysis.
BACKGROUND
Although the prognostic importance of troponin in patients with anacute coronary syndrome is clear, the significance of troponin elevation after elective percutaneous coronary intervention (PCI) is a subject of debate. However, most studies up to now had a small sample size and insufficient events during follow-up.


METHODS
Electronic and manual searches were performed of studies reporting on prognosis of troponin after elective PCI. A meta-analysis was done of all suitable studies, with death in follow-up as primary endpoint and the combination of death or nonfatal myocardial infarction in follow-up as secondary endpoint.


RESULTS
20 studies involving 15,581 patients were included. These studies were published between 1998 and 2007. Overall, troponin was elevated after elective PCI in 32.9% of patients. The follow-up period varied between 3 and 67 months (mean 16.3). Increased mortality was significantly associated with troponin elevation after PCI (4.4% vs. 3.3%, P = 0.001; OR 1.35). Furthermore, the combined endpoint of mortality or nonfatal myocardial infarction also occurred more often in patients with post-procedural troponin elevation (8.1% vs. 5.2%, P < 0.001; OR 1.59).


CONCLUSIONS
According to this meta-analysis, troponin elevation after elective PCI provides important prognostic information.
Nienhuis
Mark B
MB
Department of Cardiology, Isala klinieken, Zwolle, The Netherlands.
Ottervanger
Jan Paul
JP
Bilo
Henk J G
HJ
Dikkeschei
Bert D
BD
Zijlstra
Felix
F
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods* / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000401:mortality* / Q000628:therapy; D052279:Creatine Kinase, MB Form / Q000097:blood* / Q000378:metabolism; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood* / Q000378:metabolism
D015415:Biomarkers; D020107:Troponin T; D052279:Creatine Kinase, MB Form