Author + information
- Carla Auguadro,
- Filippo Scalise,
- Eugenio Novelli,
- Mariella Manfredi,
- Valentina Casali,
- Giuseppe Specchia and
- Policlinico di Monza
The prognostic role of minor troponin elevation after PCI is controversial.
To assess the prognostic role of troponin I (TnI) elevation after elective PCI and its relation with patients'age.
Methods and population
The study included 1532 patients (pts) who underwent elective PCI because of anginal symptoms or inducible myocardial ischemia. In all patients TnI levels were measured every 6 hours after PCI. The TnI levels ≥ 1.0 ng/ml after PCI were considered indicative of myocardial damage. Follow-up data were obtained for 1432/1532 (93.4%) pts. The events taken into account in the follow-up were: total mortality, cardiac death, hospitalization for acute myocardial infarction and/or unstable angina.
All pts were clinically stable. The following variables were predictive of MACE by univariate analysis: age ≥75 years (p=0.012), ejection fraction <50% (p=0.001), prior myocardial infarction (p=0.031) and TnI >1.0 ng/ml after PCI (p=0.04). In the global population multivariate analysis identified ejection fraction as the unique predictor of events (OR 0.97, 95% CI 0.95-0.99; p=0.012). A subanalysis was then performed to investigate the role of TnI elevation in relation to patients’ age (<75/≥75 yrs) and ejection fraction (<50/>50%). In pts with EF >50% (n=617) the incidence of total mortality, cardiac death, acute MI and MACE were significantly higher in the subgroup of pts ≥75 yrs with TnI ≥ 1.0 ng/ml. In this cohort of pts with EF ≥ 50% the multivariate analysis confirmed the TnI elevation ≥1.0 after PCI and the older age ≥75 yrs as predictive of MACE (TnI: OR 2.33, 95% CI 1.01-5.37, p=0.04; Age: OR 1.04, 95% CI 1.01-1.08, p= 0.04).
This study documented that in pts with preserved EF, regardless of age, minor TnI elevation is an independent predictor of major cardiac events in follow-up.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Stable Ischemic Heart Disease: Risk Predictors and Biomarkers
Abstract Category: 9. Chronic CAD/Stable Ischemic Heart Disease: Basic
Presentation Number: 1239M-59
- 2013 American College of Cardiology Foundation