Coronary angiography-related myocardial injury as detected by high-sensitivity cardiac troponin T assay.
OBJECTIVE
We sought to evaluate rates and mechanisms of myocardial injury and type 4a myocardial infarction (MI) after an elective diagnostic coronary angiography (CAG) as detected by high-sensitivity cardiac troponin T (hsTnT) assay.


RESULTS
Cardiac troponin concentrations were measured in consecutive patients before and after undergoing an elective CAG -with or without coronary intervention (PCI)- using an hsTnT assay. The study population consisted of 545 patients: 320 (58.7%) patients received only an elective CAG and another 225 patients (41.3%) received an additional PCI. Significant hsTnT increases occurred in 97 (30.3%) cases within the CAG group and in 152 (67.6%) cases within the PCI group. Rates of normal baseline hsTnT values (<99th percentile upper reference limit) were 75.9% in the CAG group and 71.6% in the PCI group. In cases with normal baseline hsTnT values, peak levels meeting criteria of MI type 4a according to the second or third version of the universal MI definition were observed in five (1.6%) and one (0.3%) cases within the CAG group, as well as in 32 (14.2%) and 22 (9.8%) cases within the PCI group, respectively.


CONCLUSIONS
Use of the hsTnT assay may allow identification of myocardial injury during an uneventful diagnostic coronary angiography in the absence of any coronary or non-coronary interventions.
Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany.
Haitham
H
Abu Sharar
Daniel
D
Wohlleben
Mehrshad
M
Vafaie
Arnt V
AV
Kristen
H Christian
HC
Volz
Raffi
R
Bekeredjian
Hugo A
HA
Katus
Evangelos
E
Giannitsis
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D015415:Biomarkers / Q000032:analysis; D017023:Coronary Angiography / Q000009:adverse effects*; D005260:Female; D006335:Heart Injuries / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D020107:Troponin T / Q000032:analysis* / Q000378:metabolism
D015415:Biomarkers; D020107:Troponin T