The prognostic role of troponin I elevation after elective percutaneous coronary intervention. Issue 3 (March 2015)

• Record Type: Journal Article
• Authors: Auguadro, Carla; Scalise, Filippo; Manfredi, Mariella; Casali, Valentina; Novelli, Eugenio; Specchia, Giuseppe
• Is Part Of: Journal of cardiovascular medicine. Volume 16:Issue 3(2015:Mar.)
• Publication Date: 2015-03
• Subjects: long-term outcome -- percutaneous coronary intervention -- prognosis -- troponin I; Cardiology -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cardiology -- Periodicals; Cardiovascular Diseases -- Periodicals; 616.1005
• DOI: 10.2459/JCM.0000000000000058
• Languages: English
• ISSNs: 1558-2027

Abstract

Abstract : Objectives: To assess the prognostic role of isolated troponin I (TnI) elevation after elective percutaneous coronary intervention (PCI) in patients with stable coronary artery disease. Background: The prognostic role of minor troponin elevation after PCI is controversial. Methods: A total of 1532 consecutive patients who underwent elective PCI were included. Follow-up data were obtained for 1432 of 1532 (93.4%) patients. The events taken into account in the follow-up included total mortality, cardiac death, hospitalization for acute myocardial infarction and/or unstable angina. Results: The following variables were identified as predictive of major adverse cardiac events (MACE) by univariate analysis: age 75 years at least ( P = 0.012), ejection fraction less than 50% ( P = 0.001), prior myocardial infarction ( P = 0.031) and TnI 1.0 ng/ml at least after PCI ( P = 0.04). The Cox-regression model identified the TnI elevation after PCI, the older age and the ejection fraction as independent predictors of MACE during follow-up (TnI: P = 0.042; older age: P = 0.001; ejection fraction: P = 0.003). In a subgroup of patients with preserved ejection fraction, the incidence of MACE was significantly higher in those with TnI of at least 1.0 ng/ml at least than in the ones with TnI less than 1.0 ng/ml, with the highest incidence among the older cohort. The multivariate analysis confirmed the TnI elevation 1.0 ng/ml at least after PCI and the older age as predictors of MACE. Conclusion: This study documented that in clinically stable patients, minor TnI elevations after elective PCI are independent predictors of MACE during follow-up, as are older age and reduced ejection fraction. Additionally, TnI elevation was a predictor of MACE during follow-up in a subset of patients with preserved ejection fraction. The combination of TnI elevation and older age confers the highest risk of MACE.