Baseline inflammation is not predictive of periprocedural troponin elevation after elective percutaneous coronary intervention.
High-sensitivity C-reactive protein predicts future cardiovascular events in both healthy individuals and patients with unstable and stable coronary syndromes. Few data are available about the incidence and the relation to inflammation of troponin elevation following percutaneous coronary intervention (PCI), a potential predictor of longterm outcome. We sought to confirm the impact of embolization on long-term outcome and evaluate the ability of baseline inflammation to predict troponin elevation induced by PCI. We prospectively analyzed 200 patients treated by PCI for stable or Braunwald IIA class unstable angina. The patients were recruited between January 1997 and May 1999, and the population was followed during a mean follow-up of 32 months. Major adverse cardiac events (MACEs) were defined as the occurrence of death, myocardial infarction or recurrent angina requiring repeat PCI, or coronary artery bypass grafting. During the follow-up period, 58 MACEs were observed. By multivariate analysis, independent predictors for the occurrence of MACEs were unstable angina and troponin I level after PCI (P < 0.0001 for both). No correlation was found between baseline inflammation and significant troponin I elevation post PCI and by multivariate analysis, no biological variable was a predictor of troponin I elevation post PCI. Baseline inflammation cannot predict onset of minor myonecrosis damage (expressed by troponin elevation) induced by PCI, a significant predictor of long-term outcome in this setting.
Gach
Olivier
O
Centre Hospitalier Universitaire du Sart Tilman, Domaine Universitaire du Sart Tilman (B 35), 4000 Liège 1, Belgium. oliviergach@swing.be
Louis
Olivier
O
Chapelle
Jean Paul
JP
Vanbelle
Sophie
S
Pierard
Luc A
LA
Legrand
Victor
V
D000368:Aged; D000789:Angina, Unstable / Q000097:blood / Q000209:etiology; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D023921:Coronary Stenosis / Q000097:blood / Q000150:complications / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology* / Q000401:mortality; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology; D009336:Necrosis; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I; D002097:C-Reactive Protein