title: Below normal pre-procedural cardiac troponin I levels are associated with an adverse prognosis after percutaneous coronary interventions.
abstract: OBJECTIVE
  To evaluate the prognostic implications of baseline cardiac troponin (cTn) values in the normal range in stable coronary artery disease (CAD) patients successfully treated with percutaneous coronary intervention (PCI).
  
  
  RESULTS
  We investigated the correlation between pre-procedural cTnI levels and major clinical adverse events at three years of follow-up in 1,063 consecutive stable CAD patients with normal baseline cTnI levels, successfully treated with PCI. Patients with pre-procedural cTnI levels in the upper tertile showed an increased long-term risk of overall death (HR 3.17, 95% CI: 1.62 to 6.21; p=0.0001), cardiac death (HR 5.09, 95% CI: 2.30 to 11.25; p=0.002), myocardial infarction (MI) (HR 2.34, 95% CI: 1.45 to 3.76; p=0.003) and target vessel failure (TVF) (HR 1.91, 95% CI: 1.28 to 2.84; p=0.006). Pre-procedural cTnI levels remained significantly correlated after adjustment for clinical and angiographic findings. Analysis of pre-PCI values eliminated any association of post-PCI values with prognosis.
  
  
  CONCLUSIONS
  In stable CAD patients successfully treated with PCI, pre-procedural cTnI levels, in the upper limits of the normal range, are associated with hard cardiac endpoints.
authors.affiliation: Hospital Cardiology, "Maggiore della Carità" Hospital, Novara, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lupi
authors.forename: Andrea
authors.initials: A
authors.lastname: Rognoni
authors.forename: Maurizio
authors.initials: M
authors.lastname: Lazzero
authors.forename: Roberta
authors.initials: R
authors.lastname: Rolla
authors.forename: Patrizia
authors.initials: P
authors.lastname: Pergolini
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bellomo
authors.forename: Lidia
authors.initials: L
authors.lastname: Rossi
authors.forename: Angelo
authors.initials: A
authors.lastname: Sante Bongo
authors.forename: Allan S
authors.initials: AS
authors.lastname: Jaffe
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D015536:Down-Regulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood*
chemical_list: D015415:Biomarkers; D019210:Troponin I