February 15, 2006European Heart Journal
Baseline troponin level: key to understanding the importance of post-PCI troponin elevations
Key result
Elevated baseline troponin T levels prior to PCI were associated with a higher 12-month death or MI rate compared to normal baseline levels (11.1% vs 4.7%; P<0.05).
Why the study?
Does elevated baseline troponin T predict long-term death/MI better than post-PCI troponin elevations in patients undergoing PCI?
Population
2352 patients undergoing percutaneous coronary intervention, including 1619 with no baseline cTnT elevations…
Comparison
Elevated baseline pre-PCI troponin T vs Normal baseline pre-PCI troponin T
Design
Cohort
Follow-up
12 months
Authors
Discussion
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Implication
Baseline troponin may better stratify long-term PCI risk than post-procedural rises; challenges post-PCI biomarker consensus but leaves validation open.
Study Design
Type
Cohort (n=2,352)
Structured PICO
Does elevated baseline troponin T predict long-term death/MI better than post-PCI troponin elevations in patients undergoing PCI?
P
Population
2352 patients undergoing percutaneous coronary intervention (PCI), including 1619 with no baseline cTnT elevations (97% non-urgent procedures) and 733 with baseline cTnT elevations.
I
Intervention
Elevated baseline pre-PCI troponin T (cTnT ≥0.03 ng/mL)
C
Comparator
Normal baseline pre-PCI troponin T (cTnT <0.03 ng/mL)
O
Outcome
Cumulative 12-month death/MI ratecomposite
Main Result
Absolute Event Rate: 11.1% vs 4.7%
p-value: p=<0.05
Long-term prognosis after PCI is primarily driven by baseline pre-PCI troponin levels rather than post-procedural biomarker elevations.
Cite This Study
Miller et al. (2006) conducted a cohort in Patients undergoing percutaneous coronary intervention (PCI) (n=2,352). Elevated baseline troponin T (≥0.03 ng/mL) vs. Normal baseline troponin T (<0.03 ng/mL) was evaluated on Cumulative 12-month death/MI rate (p=<0.05). Elevated baseline troponin T levels prior to PCI were associated with a higher 12-month death or MI rate compared to normal baseline levels (11.1% vs 4.7%; P<0.05).