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Prognostic significance of elevated troponin I after percutaneous coronary intervention.

Publication ,  Journal Article
Cantor, WJ; Newby, LK; Christenson, RH; Tuttle, RH; Hasselblad, V; Armstrong, PW; Moliterno, DJ; Califf, RM; Topol, EJ; Ohman, EM ...
Published in: J Am Coll Cardiol
June 5, 2002

OBJECTIVES: We sought to assess the incidence and clinical significance of elevated cardiac troponin I (cTnI) after percutaneous coronary intervention (PCI). BACKGROUND: Elevated creatine kinase-MB (CK-MB) is prognostically important after PCI, but the prognostic significance of elevated cTnI after PCI is uncertain. METHODS: In a prospective substudy of the Sibrafiban Versus Aspirin to Yield Maximum Protection From Ischemic Heart Events Post-acute Coronary Syndromes (SYMPHONY) trials, which randomized patients with acute coronary syndromes (ACS) to receive aspirin or sibrafiban, we measured cTnI (positive, > or =1.5 ng/ml) and CK-MB (positive, > or =7 ng/ml) in 481 patients with PCI. Samples were collected immediately before and at 0, 8 and 16 h after PCI and analyzed by a core laboratory. The primary end point was the Kaplan-Meier estimate of death, myocardial infarction or severe, recurrent ischemia at 90 days. RESULTS: Overall, 230 patients (48%) had elevated cTnI after PCI. Such patients underwent PCI sooner and were more likely to have coronary stenting. Elevated cTnI was associated with nonsignificantly higher risks of the primary end point (11.5% vs. 8.7%; p = 0.15) and of death (1.8% vs. 0.4%; p = 0.4) and a significantly higher risk of death or infarction (10.6% vs. 4.2%; p = 0.005). This pattern was more pronounced for patients who became positive only after PCI: primary end point, 20.7% vs. 10.1% for patients who remained negative after PCI (p = 0.05); death, 5.2% vs. 0% (p = 0.02); death or infarction, 18.1% vs. 4.1% (p = 0.007). CONCLUSIONS: Elevated cTnI, often observed after PCI in patients with ACS, is associated with worse 90-day clinical outcomes. This marker, therefore, is a useful prognostic indicator in such patients.

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Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

June 5, 2002

Volume

39

Issue

11

Start / End Page

1738 / 1744

Location

United States

Related Subject Headings

  • Troponin I
  • Stents
  • Sensitivity and Specificity
  • Prospective Studies
  • Prognosis
  • Platelet Aggregation Inhibitors
  • Piperidines
  • Oximes
  • Myocardial Infarction
  • Middle Aged
 

Citation

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Cantor, W. J., Newby, L. K., Christenson, R. H., Tuttle, R. H., Hasselblad, V., Armstrong, P. W., … SYMPHONY and 2nd SYMPHONY Cardiac Markers Substudy Investigators, . (2002). Prognostic significance of elevated troponin I after percutaneous coronary intervention. J Am Coll Cardiol, 39(11), 1738–1744. https://doi.org/10.1016/s0735-1097(02)01877-6
Cantor, Warren J., L Kristin Newby, Robert H. Christenson, Robert H. Tuttle, Vic Hasselblad, Paul W. Armstrong, David J. Moliterno, et al. “Prognostic significance of elevated troponin I after percutaneous coronary intervention.J Am Coll Cardiol 39, no. 11 (June 5, 2002): 1738–44. https://doi.org/10.1016/s0735-1097(02)01877-6.
Cantor WJ, Newby LK, Christenson RH, Tuttle RH, Hasselblad V, Armstrong PW, et al. Prognostic significance of elevated troponin I after percutaneous coronary intervention. J Am Coll Cardiol. 2002 Jun 5;39(11):1738–44.
Cantor, Warren J., et al. “Prognostic significance of elevated troponin I after percutaneous coronary intervention.J Am Coll Cardiol, vol. 39, no. 11, June 2002, pp. 1738–44. Pubmed, doi:10.1016/s0735-1097(02)01877-6.
Cantor WJ, Newby LK, Christenson RH, Tuttle RH, Hasselblad V, Armstrong PW, Moliterno DJ, Califf RM, Topol EJ, Ohman EM, SYMPHONY and 2nd SYMPHONY Cardiac Markers Substudy Investigators. Prognostic significance of elevated troponin I after percutaneous coronary intervention. J Am Coll Cardiol. 2002 Jun 5;39(11):1738–1744.
Journal cover image

Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

June 5, 2002

Volume

39

Issue

11

Start / End Page

1738 / 1744

Location

United States

Related Subject Headings

  • Troponin I
  • Stents
  • Sensitivity and Specificity
  • Prospective Studies
  • Prognosis
  • Platelet Aggregation Inhibitors
  • Piperidines
  • Oximes
  • Myocardial Infarction
  • Middle Aged