Why the study?
The comparability of cardiac troponin I and creatine kinase-MB levels after PCI in patients with normal baseline biomarker levels was unclear.
Does measurement of cTnI compared to CK-MB alter the detected rate of procedure-related infarction after PCI in patients with normal baseline biomarkers?
Observational (n=489)
Does measurement of cTnI compared to CK-MB alter the detected rate of procedure-related infarction after PCI in patients with normal baseline biomarkers?
cTnI and CK-MB provide vastly different rates of procedure-related infarction diagnosis after PCI, with cTnI yielding a >5-fold higher rate.
OBJECTIVES: To compare cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) after PCI in cases with normal baseline levels of both biomarkers. DESIGN: cTnI and CK-MB after PCI were stratified as multiples of the 99(th) percent upper reference limit (99%URL) and compared to each other in 489 patients. Post-PCI levels > three times 99%URL were classified as procedure-related infarctions. Results. After PCI, CK-MB was > 3x 99%URL in 58/486 patients (12%) and cTnI > 3x 99%URL in 292/487 patients (60%). cTnI was > 10x 99%URL in all cases with infarction according to CK-MB but CK-MB was often normal despite elevated cTnI. There was an only minimal overlap between two infarction populations, those with cTnI in the range from 1x to 10x 99%URL and those with CK-MB 1x to 10x 99%URL. CONCLUSIONS: With the present quantification scales, infarction rate after PCI is > five-fold higher with cTnI than with CK-MB.
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Gustavsson et al. (2010) conducted an observational in Patients undergoing percutaneous coronary intervention (PCI) (n=489). Cardiac troponin I (cTnI) vs. Creatine kinase-MB (CK-MB) was evaluated on Procedure-related infarction (post-PCI biomarker levels > 3 times the 99th percentile upper reference limit).
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