Introduction and objectives: The prognostic value of high-sensitivity troponin T after percutaneous coronary intervention in patients with stable coronary artery disease is unclear. We investigated this clinically relevant question in 3463 consecutive patients undergoing percutaneous coronary intervention.
Methods: This study included patients with stable coronary artery disease and baseline high-sensitivity troponin T below the 99th percentile upper reference limit (0.014μg/L). High-sensitivity troponin T was measured before and at 6, 12 and 24hours after the procedure. The primary outcome was all-cause mortality.
Results: Patients were divided into a group with peak postprocedural troponin T≤99th percentile (n=742), a group with peak postprocedural troponin T>99th to 5×99th percentile (n=1928), and a group with peak postprocedural troponin T>5×99th percentile upper reference limit (n=793). Advanced age, smaller body mass index, baseline troponin level, complex lesions, bifurcation lesions and stented length were independently associated with elevated troponin T levels after the procedure. The median follow-up was 15.5 months. There were 56 deaths: 5 deaths (1.7%) among patients with peak postprocedural troponin T≤99th percentile, 35 deaths (4.5%) among patients with peak postprocedural troponin T>99th to 5×99th percentile and 16 deaths (4.3%) among patients with peak postprocedural troponin T>5×99th percentile upper reference limit (hazard ratio=1.50; 95% confidence interval, 1.01-2.25; P=.047). After adjustment, peak postprocedural troponin T level was not independently associated with mortality after percutaneous coronary intervention (P=.094).
Conclusions: In patients with stable coronary artery disease and without elevated baseline high-sensitivity troponin T, elevated high-sensitivity troponin T level after percutaneous coronary intervention was not associated with postprocedural mortality.
Keywords: Angina estable; Coronary artery disease; Enfermedad coronaria; Intervención coronaria percutánea; Percutaneous coronary intervention; Prognosis; Pronóstico; Stable angina; Troponin; Troponina.
Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.