title: Cardiac troponin elevation pattern in patients undergoing a primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: characterization and relationship with cardiovascular events during hospitalization.
abstract: OBJECTIVE
  We aimed to describe the kinetics and associated prognostic implications of the cardiac troponin release curve after a primary percutaneous coronary intervention (PPCI) in patients presenting with ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  We prospectively determined, in a prespecified timely manner, serial cardiac troponin I levels and obtained clinical, ECG, and echocardiographic data from 175 consecutive patients hospitalized with STEMI who underwent PPCI. The median peak troponin levels and time until troponin peaking were determined.
  
  
  RESULTS
  The troponin elevation curve following PPCI was single peaked, with a median value measuring 715 times the upper normal limit and a median peaking time of 8 h. Later-peaking troponin levels were associated with a TIMI flow grade of 0/1 at the initiation of angiography and with lack of at least 70% regression in the ST-elevation on the first post-PPCI ECG. Higher peak values were similarly associated with these two parameters as well as with a lower blush score and with distal embolization during PPCI. Both higher peak values and later peaking of troponin were associated independently with higher occurrence of the combined adverse cardiovascular event outcomes consisting of death, congestive heart failure, and recurrent infarction.
  
  
  CONCLUSIONS
  The cardiac troponin elevation curve following PPCI for STEMI shows a single peak and is affected by the adequacy of myocardial reperfusion. This method can serve as a simple surrogate for risk stratification of patients with STEMI who undergo PPCI.
authors.affiliation: aDepartment of Cardiology, Leviev Heart Center, Sheba Medical Center, Tel Hashomer bCardiology Department, Barzilai Medical Center, Ashqelon cDepartment of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Buber
authors.forename: Avishag
authors.initials: A
authors.lastname: Laish-Farkash
authors.forename: Nira
authors.initials: N
authors.lastname: Koren-Morag
authors.forename: Paul
authors.initials: P
authors.lastname: Fefer
authors.forename: Amit
authors.initials: A
authors.lastname: Segev
authors.forename: Hanoch
authors.initials: H
authors.lastname: Hod
authors.forename: Shlomi
authors.initials: S
authors.lastname: Matetzky
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood*; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D019210:Troponin I