Korean Circ J.  2008 Jan;38(1):12-16. 10.4070/kcj.2008.38.1.12.

Elevated Troponin I after Implantation of Drug-Eluting Stents: Incidence, Predictors, and Prognostic Value

• Jang SW
• Seung KB
• Park HJ
• Park CS
• Kim DB
• Kim SH
• Kim PJ
• Jung HO
• Baek SH
• Choi KB

• KMID: 2225868
• DOI: http://doi.org/10.4070/kcj.2008.38.1.12

Abstract

BACKGROUND AND OBJECTIVES
The presence of elevated troponin after percutaneous coronary intervention (PCI) is considered to reflect irreversible myocardial injury. However, its prognostic value remains unclear. The purpose of this study was to investigate the incidence, risk factors, and clinical outcomes of troponin I (TnI) elevation after the implantation of drug-eluting stent (DES).
SUBJECTS AND METHODS
We performed a retrospective analysis of 335 patients who had undergone PCI with DES. Patients who had acute coronary syndrome with elevated TnI levels before PCI were excluded. TnI levels were measured 6 and 24 hours after PCI. RESULTS: Baseline clinical characteristics were similar in the elevated TnI and normal TnI groups. Elevated postprocedural TnI (>1.5 ng/mL) occurred in 52 patients (15.5%). Univariate analysis revealed that the clinically significant variables were multi-vessel disease (p<0.001), multiple stent implantation (p=0.003), total stent length (p=0.001), side-branch occlusion (p<0.001), and bifurcation lesion (p=0.003). Multivariate analysis indicated that the independent predictors of elevated TnI after DES implantation were multi-vessel disease (p=0.019), side-branch occlusion (p=0.001), and bifurcation (p=0.011). There were no significant differences in major adverse cardiovascular events between the elevated TnI and normal TnI groups (p=0.461).
CONCLUSION
Multi-vessel disease, side-branch occlusion, and bifurcation were independent predictors of elevated TnI following DES implantation. The elevation of TnI after successful PCI with DES was not associated with worse 400-day clinical outcomes.

Keyword

Troponin I; Coronary stenosis; Angioplasty, transluminal, percutaneous coronary; Stents

MeSH Terms

Acute Coronary Syndrome
Angioplasty, Balloon, Coronary
Coronary Stenosis
Drug-Eluting Stents
Humans
Incidence
Multivariate Analysis
Percutaneous Coronary Intervention
Retrospective Studies
Risk Factors
Stents
Troponin
Troponin I
Troponin
Troponin I

Figure

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  Fig. 1 Kaplan-Meier curves for event-free survival in troponin I (TnI)-positive and TnI-negative groups after implantation of drug-eluting stents.

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  Fig. 2 Kaplan-Meier curves for event-free survival in creatinine kinase (CK)-MB-positive and CK-MB-negative groups after implantation of drug-eluting stents.

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