1. Troponin I elevation and all-cause mortality after elective percutaneous coronary interventions.
- Author
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Ferreira RM, de Souza E Silva NA, Salis LHA, da Silva RRM, Maia PD, Horta LFB, Salles EF, Nunes HMP, de Oliveira JBM, Domingues YPS, and de Sousa CCM
- Subjects
- Aged, Biomarkers blood, Brazil, Coronary Disease diagnostic imaging, Coronary Disease mortality, Female, Humans, Kaplan-Meier Estimate, Male, Medical Records, Middle Aged, Percutaneous Coronary Intervention adverse effects, Protective Factors, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Up-Regulation, Coronary Disease therapy, Percutaneous Coronary Intervention mortality, Troponin I blood
- Abstract
Background/purpose: Although troponin I (TnI) elevation and myocardial injury after percutaneous coronary interventions (PCI) are frequent findings, their prognoses remain controversial. We aimed to determine the association between any or ≥5 times TnI elevation after elective PCI and subsequent one year mortality rates and long term survival., Methods: Consecutive patients admitted for elective PCI between January 2013 and December 2014 were retrospectively analyzed by chart review in two hospitals in Rio de Janeiro. Only patients with post-PCI TnI measurements were included. Clinical, angiographic and procedural characteristics were correlated with any or ≥5 times TnI elevation, as well as 1year mortality and long term survival., Results: A total of 407 interventions were included in the analysis. Post-PCI TnI elevation was observed in 74.7% of cases and ≥5 times elevations occurred in 41.3%. Age≥70years, female gender and multistenting were predictors of enzyme elevation. Prior aspirin or hypoglycemic therapy were protective factors. One year mortality was significantly associated with any TnI elevation (6.6% vs 1.05%, p=0.035) and values ≥5 times above the normal limit predicted the highest mortality rates (8.13% vs 3.14%, p=0.031). Survival of patients with single vessel disease was also adversely affected by ≥5 times enzyme elevation (log-rank: p=0.039)., Conclusion: Troponin I elevation after elective PCI is frequent and associated with progressively higher mortality rates at 1year. A cutoff value ≥5 times the 99th percentile, currently defined as myocardial injury, appears to be an even more significant predictor of this outcome, even in lower risk subgroups., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2017
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