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

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 (≥16 U/L and/or TnT (≥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