Key result
Post-PCI CK-MB elevation, but not troponin, is linked to ~90% higher 2-year mortality.
Why the study?
The long-term mortality risk of mild post-PCI CK-MB elevations remains controversial, and the prognostic significance of post-procedural cardiac troponin elevations has not been established.
Does post-procedural elevation of CK-MB or cTnI predict 2-year mortality in patients undergoing PCI?
Population
3494 consecutive patients undergoing PCI in 16 Italian tertiary centres
Comparison
Post-procedural elevation of CK-MB or cTnI vs no elevation
Design
Multicentre prospective cohort study
Follow-up
2 years
Loading...
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“This large cohort follow-up study is of particular relevance for the interventional cardiologist, as it gives further data about the impact of procedure-induced myonecrosis on long-term outcome following PCI.”
“Although we agree that calculating the peak ratio in the case of high baseline levels is arbitrary and may lead to an underestimate of the degree of elevation, we consider it a reasonable attempt to separate the amount of myocardial damage due to the interventional procedure per se from that attributed to pre-procedural myocardial necrosis.”
Post-PCI CK-MB elevations may signal higher long-term mortality; leaves open independent prognostic value of troponin elevations.
Cohort (n=3,494)
Yes
Does post-procedural elevation of CK-MB or cTnI predict 2-year mortality in patients undergoing PCI?
Odds Ratio: 1.9 (95% CI 1.3–2.8)
Absolute Event Rate: 7.2% vs 3.8%
p-value: p=<0.001
Post-procedural elevation of CK-MB, but not cTnI, is an independent predictor of 2-year mortality following PCI.
A 2005 study conducted a cohort in Patients undergoing percutaneous coronary intervention (PCI) (n=3,494). Post-procedural elevation of CK-MB vs. No CK-MB elevation was evaluated on 2-year mortality (OR 1.9, 95% CI 1.3-2.8, p=<0.001). Post-procedural elevation of CK-MB, but not troponin I, was associated with increased 2-year mortality after PCI (7.2% vs. 3.8%; OR 1.9; 95% CI 1.3-2.8; P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: