Korean Circ J.  2002 Nov;32(11):949-957. 10.4070/kcj.2002.32.11.949.

Impact on Long-term Adverse Cardiac Events of Troponin T or Creatine Kinase-MB Release after Percutaneous Transluminal Coronary Angioplasty

• Cho BR
• Hong KP
• Gwon HC
• Sung JD
• Lee SH
• Park JE
• Seo JD
• Lee WR
• Choi SK

• KMID: 1858714
• DOI: http://doi.org/10.4070/kcj.2002.32.11.949

Abstract

BACKGROUND AND OBJECTIVES: The impact on long-term adverse cardiac events of troponin T (TnT) or creatine kinase-MB (CK-MB) release after percutaneous transluminal coronary angioplasty (PTCA) is not well defined. The purpose of the study is to evaluate the effect of elevated TnT or CK-MB on the late major adverse cardiac events [MACE ; Q wave myocardial infarction (MI), revascularization, or cardiac death].
SUBJECTS AND METHODS
Study population were 207 consecutive patients (M : F=148 : 59, mean 60.8+/-9.2 years) who underwent PTCA. Patients with acute MI, unstable angina with abnormal levels of TnT or CK-MB, or newly developed Q MI after PTCA were excluded. Cardiac enzyme levels were measured before and 8, 24 hours after PTCA for CK-MB, and before and 16 hours after PTCA for TnT. Group I (n=181, 87.4%) had normal levels of both after PTCA. Group II (n=26, 12.6%) had abnormal levels of CK-MB (>or=16 U/L) and/or TnT (>or=0.2 ng/mL). 1-year follow-up was available in 201 (97.1%) patients.
RESULTS
Incidence of non-Q MI after PTCA was 26/207 (12.6%). Major complications such as acute coronary occlusion, side branch occlusion, and major dissection were significantly associated with elevation of TnT or CK-MB after PTCA (p=0.01). However, elevation of CK-MB or TnT was not significantly associated with late MACE by Kaplan-Meier survival curve (p=0.46). During 1-year follow-up, event free rate of group I and II were 76.6% and 69.2%, respectively.
CONCLUSION
Acute coronary occlusion, side branch occlusion, or major dissection can increase the level of TnT or CK-MB after PTCA. But, elevation of CK-MB or TnT after PTCA dose not significantly influence on late MACE.

Keyword

Angioplasty; transluminal; percutaneous coronary; Creatine kinase; Myocardial infarction; Troponin T.

MeSH Terms

Angina, Unstable
Angioplasty
Angioplasty, Balloon, Coronary*
Coronary Occlusion
Creatine Kinase
Creatine*
Follow-Up Studies
Humans
Incidence
Myocardial Infarction
Trinitrotoluene
Troponin T*
Troponin*
Creatine
Creatine Kinase
Trinitrotoluene
Troponin
Troponin T