September 8, 2004Circulation
Elevations in Troponin I After Percutaneous Coronary Interventions Are Associated With Abnormal Tissue-Level Perfusion in High-Risk Patients With Non–ST-Segment–Elevation Acute Coronary Syndromes
Key result
Postprocedural cTnI elevation in high-risk NSTE-ACS patients undergoing PCI is associated with abnormal tissue-level perfusion (TMPG 0/1 in 43% vs 7%; P<0.02).
Why the study?
Is postprocedural cTnI elevation associated with abnormal tissue-level perfusion in high-risk patients with NSTE-ACS undergoing PCI?
Population
42 high-risk patients with non-ST-segment-elevation acute coronary syndromes presenting with angina at rest…
Comparison
Percutaneous coronary intervention performed… vs Patients without postprocedural cTnI elevation
Design
Cohort
Follow-up
Immediately after PCI
Authors
Discussion
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Implication
May reflect microvascular dysfunction after PCI; hypothesis-generating for targeted perfusion strategies in NSTE-ACS.
Study Design
Type
Observational (n=42)
Structured PICO
Is postprocedural cTnI elevation associated with abnormal tissue-level perfusion in high-risk patients with NSTE-ACS undergoing PCI?
P
Population
42 high-risk patients with non-ST-segment-elevation acute coronary syndromes (NSTE-ACS) presenting with angina at rest, unequivocal ST-segment depression, and cTnI elevation
I
Intervention
Percutaneous coronary intervention (PCI) performed within 24 to 48 hours of hospital admission, with glycoprotein IIb/IIIa inhibitors
C
Comparator
Patients without postprocedural cTnI elevation
O
Outcome
Relationship between postprocedural troponin I (cTnI) elevation and tissue-level perfusion (assessed by TIMI flow grade, corrected TIMI frame count, TIMI myocardial perfusion grade [TMPG], and myocardial contrast enhancement [MCE])surrogate
Main Result
Absolute Event Rate: 43% vs 7%
p-value: p=<0.02
Postprocedural troponin I elevation after PCI in high-risk NSTE-ACS patients is associated with abnormal tissue-level perfusion, suggesting microvascular dysfunction as a pathophysiological mechanism.
Cite This Study
Bolognese et al. (2004) conducted an observational in High-risk non-ST-segment-elevation acute coronary syndromes (NSTE-ACS) (n=42). Postprocedural cTnI elevation vs. No postprocedural cTnI elevation was evaluated on TIMI myocardial perfusion grade (TMPG) 0/1 after PCI (p=<0.02). Postprocedural cTnI elevation in high-risk NSTE-ACS patients undergoing PCI is associated with abnormal tissue-level perfusion (TMPG 0/1 in 43% vs 7%; P<0.02).