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Prevalence and prognostic significance of preprocedural cardiac troponin elevation among patients with stable coronary artery disease undergoing percutaneous coronary intervention: results from the evaluation of drug eluting stents and ischemic events registry.

Publication ,  Journal Article
Jeremias, A; Kleiman, NS; Nassif, D; Hsieh, W-H; Pencina, M; Maresh, K; Parikh, M; Cutlip, DE; Waksman, R; Goldberg, S; Berger, PB; Cohen, DJ ...
Published in: Circulation
August 5, 2008

BACKGROUND: Although cardiac troponin (cTn) elevation is associated with periprocedural complications during percutaneous coronary intervention (PCI) in the setting of acute coronary syndromes, the prevalence and prognostic significance of preprocedural cTn elevation among patients with stable coronary artery disease undergoing PCI are unknown. METHODS AND RESULTS: Between July 2004 and September 2006, 7592 consecutive patients who underwent attempted stent placement at 47 hospitals throughout the United States were enrolled in a prospective multicenter registry. We analyzed the frequency of an elevated cTn immediately before PCI and its relationship to in-hospital and 1-year outcomes among patients who underwent PCI for either stable angina or a positive stress test. Among the stable coronary artery disease population (n=2382, 31.4%), 142 (6.0%) had a cTn level above the upper limit of normal before the procedure. Compared with patients who had normal baseline cTn, patients with elevated cTn had a higher rate of in-hospital death or myocardial infarction (13.4% versus 5.6%; P<0.001) and a trend toward higher rates of urgent repeat PCI (1.4% versus 0.2%; P=0.06). In multivariable analyses adjusted for demographic, clinical, angiographic, and procedural factors, baseline cTn elevation remained independently associated with the composite of death or myocardial infarction at hospital discharge (odds ratio, 2.1; 95% confidence interval, 1.2 to 3.8; P=0.01) and at the 1-year follow-up (odds ratio, 2.0; 95% confidence interval, 1.2 to 3.3; P=0.005). CONCLUSIONS: Baseline elevation of cTn is relatively common among patients with stable coronary artery disease undergoing PCI and is an independent prognostic indicator of ischemic complications. If these data are confirmed in future studies, consideration should be given to routine testing of cTn before performance of PCI in this patient population.

Duke Scholars

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

August 5, 2008

Volume

118

Issue

6

Start / End Page

632 / 638

Location

United States

Related Subject Headings

  • Troponin T
  • Treatment Outcome
  • Risk Factors
  • Registries
  • Prognosis
  • Prevalence
  • Predictive Value of Tests
  • Myocardial Ischemia
  • Middle Aged
  • Kidney Diseases
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Jeremias, A., Kleiman, N. S., Nassif, D., Hsieh, W.-H., Pencina, M., Maresh, K., … Evaluation of Drug Eluting Stents and Ischemic Events (EVENT) Registry Investigators, . (2008). Prevalence and prognostic significance of preprocedural cardiac troponin elevation among patients with stable coronary artery disease undergoing percutaneous coronary intervention: results from the evaluation of drug eluting stents and ischemic events registry. Circulation, 118(6), 632–638. https://doi.org/10.1161/CIRCULATIONAHA.107.752428
Jeremias, Allen, Neal S. Kleiman, Deborah Nassif, Wen-Hua Hsieh, Michael Pencina, Kelly Maresh, Manish Parikh, et al. “Prevalence and prognostic significance of preprocedural cardiac troponin elevation among patients with stable coronary artery disease undergoing percutaneous coronary intervention: results from the evaluation of drug eluting stents and ischemic events registry.Circulation 118, no. 6 (August 5, 2008): 632–38. https://doi.org/10.1161/CIRCULATIONAHA.107.752428.
Jeremias A, Kleiman NS, Nassif D, Hsieh W-H, Pencina M, Maresh K, Parikh M, Cutlip DE, Waksman R, Goldberg S, Berger PB, Cohen DJ, Evaluation of Drug Eluting Stents and Ischemic Events (EVENT) Registry Investigators. Prevalence and prognostic significance of preprocedural cardiac troponin elevation among patients with stable coronary artery disease undergoing percutaneous coronary intervention: results from the evaluation of drug eluting stents and ischemic events registry. Circulation. 2008 Aug 5;118(6):632–638.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

August 5, 2008

Volume

118

Issue

6

Start / End Page

632 / 638

Location

United States

Related Subject Headings

  • Troponin T
  • Treatment Outcome
  • Risk Factors
  • Registries
  • Prognosis
  • Prevalence
  • Predictive Value of Tests
  • Myocardial Ischemia
  • Middle Aged
  • Kidney Diseases