title: Multimarker risk stratification approach and cardiovascular outcomes in patients with stable coronary artery disease undergoing elective percutaneous coronary intervention.
abstract: OBJECTIVE
  We studied the utility of multimarker risk stratification approach to predict cardiovascular outcomes in patients with stable coronary artery disease, undergoing elective percutaneous coronary intervention (PCI).
  
  
  METHODS
  We prospectively evaluated 302 consecutive patients with stable coronary artery disease and normal CPK-MB and cardiac troponin T levels, and who underwent elective PCI at our institution. The following cardiac biomarkers were measured before and between 12 and 24h post-procedure: CK-MB, cardiac troponin T, hs-CRP, and NT-ProBNP. Patients were followed up for a minimum of 6 months.
  
  
  RESULTS
  Post-PCI, CPK-MB levels were elevated but below myocardial infarction (MI) range in 70 patients (23%), and in the MI range in 6 patients (2%). Troponin T levels were detectable but below the 99th percentile (microleak) in 32 patients (10.6%) and elevated above the 99th percentile (periprocedural MI) in 104 patients (34.4%). At 9 months' follow-up, 1% died, 2% had stable angina, 10.3% had non-fatal MI, and 87.7% remained asymptomatic. There was no significant difference in clinical events among groups stratified by elevation of one biomarker or multiple biomarkers.
  
  
  CONCLUSIONS
  Single or multiple biomarker strategy in patients with normal baseline biomarkers failed to predict major cardiac events after PCI over medium-term follow-up.
authors.affiliation: Department of Cardiology, G.B. Pant Hospital, Delhi, India.
authors.forename: Vimal
authors.initials: V
authors.lastname: Mehta
authors.affiliation: Department of Medicine, Division of Cardiology, IU Health La Porte Hospital, IN, United States.
authors.forename: Rishi
authors.initials: R
authors.lastname: Sukhija
authors.affiliation: Department of Cardiology, G.B. Pant Hospital, Delhi, India.
authors.forename: Pratishtha
authors.initials: P
authors.lastname: Mehra
authors.affiliation: Department of Cardiology, G.B. Pant Hospital, Delhi, India.
authors.forename: Anuj
authors.initials: A
authors.lastname: Goyal
authors.affiliation: Department of Cardiology, G.B. Pant Hospital, Delhi, India.
authors.forename: Jamal
authors.initials: J
authors.lastname: Yusuf
authors.affiliation: Department of Biochemistry, G.B. Pant Hospital, Delhi, India.
authors.forename: Bhawna
authors.initials: B
authors.lastname: Mahajan
authors.affiliation: Department of Biochemistry, G.B. Pant Hospital, Delhi, India.
authors.forename: V K
authors.initials: VK
authors.lastname: Gupta
authors.affiliation: Department of Cardiology, G.B. Pant Hospital, Delhi, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Tyagi
authors.affiliation: Department of Medicine, Division of Cardiology, Mount Sinai Hospital, NY, United States. Electronic address: chandrasekar.palaniswamy@mountsinai.org.
authors.forename: Chandrasekar
authors.initials: C
authors.lastname: Palaniswamy
authors.affiliation: Department of Medicine, Division of Cardiology, New York Medical College at Westchester Medical Center, Valhalla, NY, United States.
authors.forename: Wilbert S
authors.initials: WS
authors.lastname: Aronow
mesh_terms: D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D002423:Cause of Death / Q000639:trends; D003324:Coronary Artery Disease / Q000097:blood / Q000453:epidemiology* / Q000601:surgery; D052279:Creatine Kinase, MB Form / Q000097:blood; D017558:Elective Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D020107:Troponin T / Q000097:blood
chemical_list: D015415:Biomarkers; D020107:Troponin T; D002097:C-Reactive Protein; D052279:Creatine Kinase, MB Form
keywords: Biomarkers; Major adverse cardiovascular event; Percutaneous coronary intervention; Periprocedural myocardial infarction