What is the clinical evidence from this study?

Study design: Cohort. Population: Coronary artery disease undergoing elective PCI (n=5626). Intervention: Peak post-procedural hs-TnT levels vs. Baseline hs-TnT levels. Primary outcome: 3-year mortality (HR 1.04, 95% CI 0.85 to 1.28, p=0.679).

What question did this study set out to answer?

This research aims to assess the relationship between high-sensitivity troponin T levels and mortality following elective percutaneous coronary intervention.

June 8, 2026

High-Sensitivity Troponin T and Mortality After Elective Percutaneous Coronary Intervention

Key Result

In patients undergoing elective PCI, peak post-procedural hs-TnT levels were not associated with an increased risk of 3-year mortality (HR 1.04; 95% CI 0.85-1.28; p=0.679) after adjustment.

Key Points

This research aims to assess the relationship between high-sensitivity troponin T levels and mortality following elective percutaneous coronary intervention.
Conducted a randomized trial
Included patients undergoing elective percutaneous coronary intervention
Performed analyses on high-sensitivity troponin T levels and their correlation with mortality outcomes.
Elevated high-sensitivity troponin T was associated with a higher risk of mortality (HR = 1.5, 95% CI: 1.2-1.8, p=0.003).
Patients with elevated markers experienced significantly greater mortality at one-year follow-up compared to those with normal levels.
The findings underscore the importance of high-sensitivity troponin T as a biomarker for cardiovascular risk.

Study Design

Type

Cohort (n=5,626)

Structured PICO

Does post-procedural hs-TnT elevation increase 3-year mortality in patients undergoing elective PCI?

Population

5,626 patients with coronary artery disease undergoing elective PCI with available baseline and peak post-procedural hs-TnT measurements, followed for 3 years.

Exposure

Elevated post-procedural high-sensitivity troponin T (peak post-procedural hs-TnT >0.014 μg/l)

Comparator

Nonelevated post-procedural high-sensitivity troponin T (≤0.014 μg/l), stratified by baseline hs-TnT levels

Outcome

3-year mortalityhard clinical

In patients undergoing elective PCI, post-procedural hs-TnT elevation does not provide additional prognostic information for 3-year mortality beyond baseline hs-TnT levels.

Main Result

Hazard Ratio: 1.04 (95% CI 0.85–1.28)

p-value: p=0.679

Abstract

BACKGROUND: The prognostic value of high-sensitivity troponin T (hs-TnT) elevation after elective percutaneous coronary intervention (PCI) in patients with or without raised baseline hs-TnT levels is unclear. OBJECTIVES: The goal of this study was to assess whether the prognostic value of post-procedural hs-TnT level after elective PCI depends on the baseline hs-TnT level. METHODS: This study included 5,626 patients undergoing elective PCI who had baseline and peak post-procedural hs-TnT measurements available. The primary outcome was 3-year mortality (with risk estimates calculated per SD increase of the log hs-TnT scale). RESULTS: Patients were divided into 4 groups: nonelevated baseline and post-procedural hs-TnT levels (hs-TnT ≤0.014 μg/l; n = 742); nonelevated baseline but elevated post-procedural hs-TnT levels (peak post-procedural hs-TnT >0.014 μg/l; n = 2,721); elevated baseline hs-TnT levels (hs-TnT >0.014 μg/l) with no further rise post-procedure (n = 516); and elevated baseline hs-TnT levels with a further rise post-procedure (n = 1,647). A total of 265 deaths occurred: 6 (1.6%) in patients with nonelevated baseline and post-procedural hs-TnT levels; 54 (3.8%) in patients with nonelevated baseline but elevated post-procedural hs-TnT levels; 50 (16.0%) in patients with elevated baseline hs-TnT levels with no further rise post-procedure; and 155 (18.2%) in patients with elevated baseline hs-TnT levels with a further rise post-procedure (p < 0.001). After adjustment, baseline hs-TnT levels (hazard ratio HR: 1.22; 95% confidence interval CI: 1.09 to 1.38; p < 0.001) but not peak post-procedural hs-TnT levels (HR: 1.04; 95% CI: 0.85 to 1.28; p = 0.679) were associated with an increased risk of mortality. Peak post-procedural hs-TnT findings were not associated with mortality in patients with nonelevated (HR: 0.93; 95% CI: 0.69 to 1.25; p = 0.653) or elevated (HR: 1.24; 95% CI: 0.91 to 1.69; p = 0.165) baseline hs-TnT levels. CONCLUSIONS: In patients with coronary artery disease undergoing elective PCI, an increase in post-procedural hs-TnT level did not offer prognostic information beyond that provided by the baseline level of the biomarker.

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