Key result
An elevation in cardiac troponins after percutaneous coronary intervention was not an independent predictor of increased major adverse cardiac events (HR 1.35; 95% CI 0.74-2.46; P=0.33).
Why the study?
Does minor elevation of cardiac troponins after PCI predict major adverse cardiac events in patients with stable angina or NSTE-ACS?
Cohort (n=1,008)
Double-blind
No
Does minor elevation of cardiac troponins after PCI predict major adverse cardiac events in patients with stable angina or NSTE-ACS?
Hazard Ratio: 1.35 (95% CI 0.74–2.46)
p-value: p=0.33
Minor elevations in cardiac troponins following PCI are relatively uncommon and do not independently predict major adverse cardiac events in a Chinese population.
Post-PCI troponin elevation should not yet guide risk stratification in stable angina or NSTE-ACS; leaves open its prognostic value in broader populations.
Cardiac troponin-I (cTnI) and -T (cTnT) are sensitive and specific markers of myocardial injury. However, the role of increased cTnI and cTnT in percutaneous coronary intervention (PCI)-related myocardial injury remains controversial. In this prospective, single-center and double-blind study, we aimed to determine the diagnostic and prognostic value of cTnI as well as cTnT (cTns) in PCI-related myocardial injury in a Chinese population. A total of 1,008 patients with stable angina pectoris and non-ST-segment elevation acute coronary syndrome were recruited. The levels of cTnI and cTnT were examined before and after PCI. All patients were followed up for 26±9 months to observe the incidence of major adverse cardiac events (MACEs). Our results showed that post-PCI cTnI and/or cTnT levels were increased to more than the 99(th) percentile upper reference limit (URL) in 133 (13.2%) patients, among which 22 (2.2%) were more than 5 × 99(th) percentile URL. By univariate analysis, an elevation in cTns after PCI was not an independent predictor of increased MACEs, HR 1.35 (P = 0.33, 95%CI: 0.74-2.46). In conclusion, our data demonstrate that the incidence of PCI-related myocardial injury is not common in a Chinese population and minor elevated cTns levels may not be a sensitive prognostic marker for MACEs.
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Zhang et al. (2014) conducted a cohort in stable angina pectoris and non-ST-segment elevation acute coronary syndrome (n=1,008). Elevated cardiac troponin levels post-PCI vs. Normal cardiac troponin levels post-PCI was evaluated on major adverse cardiac events (MACEs) (HR 1.35, 95% CI 0.74-2.46, p=0.33). An elevation in cardiac troponins after percutaneous coronary intervention was not an independent predictor of increased major adverse cardiac events (HR 1.35; 95% CI 0.74-2.46; P=0.33).
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