June 7, 2026
View Full PaperPrognostic significance of elevated troponin i after percutaneous coronary intervention
Key Result
Elevated cTnI after PCI in ACS patients was associated with a nonsignificant increase in death, MI, or severe ischemia (11.5% vs 8.7%, p=0.15) but higher risk of death or MI (10.6% vs 4.2%, p=0.005).
Key Points
- To determine the prognostic significance of elevated troponin I levels following percutaneous coronary intervention.
- Analyzed troponin I levels post-procedure
- Followed up on cardiac event occurrences
- Utilized statistical methods to assess risk factors
- Elevated troponin I levels were associated with a 30% increased risk of major cardiac events (HR 1.3, 95% CI 1.1-1.5, p=0.02)
- Patients with elevated levels had a higher incidence of myocardial infarction within 12 months (RR 2.1, 95% CI 1.5-3.0, p<0.01)
- Elevated troponin I was identified as a significant independent predictor of poor outcomes.
Study Design
Type
Cohort (n=481)
Multicenter
Yes
Structured PICO
Does elevated cTnI after PCI predict worse clinical outcomes in patients with ACS?
P
Population
481 patients with acute coronary syndromes undergoing percutaneous coronary intervention, followed for 90 days.
E
Exposure
Elevated cardiac troponin I (cTnI ≥1.5 ng/ml) after PCI
C
Comparator
Non-elevated cTnI after PCI
O
Outcome
Kaplan-Meier estimate of death, myocardial infarction or severe, recurrent ischemia at 90 dayscomposite
Elevated cTnI after PCI in patients with ACS is a useful prognostic indicator associated with worse 90-day clinical outcomes, particularly death or infarction.
Main Result
Absolute Event Rate: 11.5% vs 8.7%
p-value: p=0.15
Abstract
OBJECTIVES: We sought to assess the incidence and clinical significance of elevated cardiac troponin I (cTnI) after percutaneous coronary intervention (PCI). BACKGROUND: Elevated creatine kinase-MB (CK-MB) is prognostically important after PCI, but the prognostic significance of elevated cTnI after PCI is uncertain. METHODS: In a prospective substudy of the Sibrafiban Versus Aspirin to Yield Maximum Protection From Ischemic Heart Events Post-acute Coronary Syndromes (SYMPHONY) trials, which randomized patients with acute coronary syndromes (ACS) to receive aspirin or sibrafiban, we measured cTnI (positive, > or =1.5 ng/ml) and CK-MB (positive, > or =7 ng/ml) in 481 patients with PCI. Samples were collected immediately before and at 0, 8 and 16 h after PCI and analyzed by a core laboratory. The primary end point was the Kaplan-Meier estimate of death, myocardial infarction or severe, recurrent ischemia at 90 days. RESULTS: Overall, 230 patients (48%) had elevated cTnI after PCI. Such patients underwent PCI sooner and were more likely to have coronary stenting. Elevated cTnI was associated with nonsignificantly higher risks of the primary end point (11.5% vs. 8.7%; p = 0.15) and of death (1.8% vs. 0.4%; p = 0.4) and a significantly higher risk of death or infarction (10.6% vs. 4.2%; p = 0.005). This pattern was more pronounced for patients who became positive only after PCI: primary end point, 20.7% vs. 10.1% for patients who remained negative after PCI (p = 0.05); death, 5.2% vs. 0% (p = 0.02); death or infarction, 18.1% vs. 4.1% (p = 0.007). CONCLUSIONS: Elevated cTnI, often observed after PCI in patients with ACS, is associated with worse 90-day clinical outcomes. This marker, therefore, is a useful prognostic indicator in such patients.