Subtle myocardial damage associated with diagnostic coronary angiography alone.
OBJECTIVE
To evaluate the frequency, predictors and prognostic significance of elevation in cardiac troponin I (cTnI) after coronary angiography (CAG).


RESULTS
A series of 296 consecutive patients with normal pre-procedural cTnI levels and undergoing elective CAG at our centre were prospectively analysed. Positive cTnI elevation was defined as >0.06 ng/ml. Positive cTnI elevation was observed in 44 patients (14.8%), but CK-MB was elevated in only four patients (1.3%) after the procedure. The risk of cTnI elevation was independently associated with left ventricular hypertrophy (odds ratio [OR] 5.52; 95% confidence interval [CI], 2.54 to 12.02; P<0.001), inexperienced operator (OR 10.83; 95% CI, 2.47 to 47.43; P=0.002) and the amount of contrast agent (OR 1.12; 95% CI, 1.03 to 1.23; P=0.009 for each 10 ml increase), whereas it was not associated with the severity of coronary artery disease. At one year, however, postprocedural elevation of cTnI was not associated with an increased risk of death (2.3% vs. 0.8%, P=0.384) or myocardial infarction (2.3% vs. 2.0%, P=0.623).


CONCLUSIONS
A minor elevation of cTnI is observed commonly after CAG, which might be associated with left ventricular hypertrophy, operator's experience and the amount of contrast used; however, it does not influence 1-year events rates.
Umeda
Hisashi
H
Toyota Memorial Hospital, Bantane Hospital, Fujita Health University, Nagoya University Graduate School of Medicine, Japan. humedamd@ybb.ne.jp
Ota
Tomoyuki
T
Iwase
Mitsunori
M
Izawa
Hideo
H
Miyata
Shinjiro
S
Sugino
Shigeo
S
Hayashi
Kazutaka
K
Misumida
Naoki
N
Takeichi
Yasushi
Y
Ishiki
Ryoji
R
Inagaki
Haruo
H
Murohara
Toyoaki
T
D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography / Q000009:adverse effects*; D003327:Coronary Disease / Q000097:blood / Q000000981:diagnostic imaging*; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009206:Myocardium / Q000378:metabolism*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I; D003402:Creatine Kinase