BACKGROUND: C-reactive protein (CRP), a marker of inflammation, plays a role in the pathophysiology of atherosclerotic events. The relationship between CRP levels and myocardial necrosis assessed by troponin T (TnT) in patients undergoing percutaneous coronary intervention (PCI) has not been established. In addition, the long-term significance of TnT rise following PCI is not clear. OBJECTIVES: To examine the relationship between CRP and the rise in TnT levels, and evaluate the long-term prognostic implications of TnT rise following PCI. METHODS: A total of 1208 patients underwent successful nonemergent PCI. Baseline demographic characteristics, CRP and TnT levels were prospectively collected before and 12 h to 18 h following PCI. Long-term follow-up data over two years were available. RESULTS: Among the patients studied (mean age 62 years), 64% presented with acute coronary syndrome. A PCI procedure was associated with a significant increase in TnT levels (higher than 0.1 microg/L) in 238 patients (20%). Multivariate logistic regression identified presentation with acute coronary syndrome or myocardial infarction, no statin use at the time of the procedure, increased CRP and increasing length of stent as independent predictors of TnT rise following PCI. Periprocedural TnT rise was not associated with adverse events in follow-up examinations (OR 1.09, 95% CI 0.73 to 1.65). CONCLUSIONS: Myocardial necrosis commonly occurred in otherwise successful PCI and was particularly prevalent in the proinflammatory milieu of a recent myocardial infarction. This response was blunted with statin therapy. However, there was no long-term adverse sequelae of these troponin rises following otherwise uncomplicated PCI.
BACKGROUND:C-reactive protein (CRP), a marker of inflammation, plays a role in the pathophysiology of atherosclerotic events. The relationship between CRP levels and myocardial necrosis assessed by troponin T (TnT) in patients undergoing percutaneous coronary intervention (PCI) has not been established. In addition, the long-term significance of TnT rise following PCI is not clear. OBJECTIVES: To examine the relationship between CRP and the rise in TnT levels, and evaluate the long-term prognostic implications of TnT rise following PCI. METHODS: A total of 1208 patients underwent successful nonemergent PCI. Baseline demographic characteristics, CRP and TnT levels were prospectively collected before and 12 h to 18 h following PCI. Long-term follow-up data over two years were available. RESULTS: Among the patients studied (mean age 62 years), 64% presented with acute coronary syndrome. A PCI procedure was associated with a significant increase in TnT levels (higher than 0.1 microg/L) in 238 patients (20%). Multivariate logistic regression identified presentation with acute coronary syndrome or myocardial infarction, no statin use at the time of the procedure, increased CRP and increasing length of stent as independent predictors of TnT rise following PCI. Periprocedural TnT rise was not associated with adverse events in follow-up examinations (OR 1.09, 95% CI 0.73 to 1.65). CONCLUSIONS:Myocardial necrosis commonly occurred in otherwise successful PCI and was particularly prevalent in the proinflammatory milieu of a recent myocardial infarction. This response was blunted with statin therapy. However, there was no long-term adverse sequelae of these troponin rises following otherwise uncomplicated PCI.
Authors: Joseph B Selvanayagam; Italo Porto; Keith Channon; Steffen E Petersen; Jane M Francis; Stefan Neubauer; Adrian P Banning Journal: Circulation Date: 2005-02-21 Impact factor: 29.690
Authors: A Buffon; G Liuzzo; L M Biasucci; P Pasqualetti; V Ramazzotti; A G Rebuzzi; F Crea; A Maseri Journal: J Am Coll Cardiol Date: 1999-11-01 Impact factor: 24.094
Authors: P M Ridker; N Rifai; M A Pfeffer; F M Sacks; L A Moye; S Goldman; G C Flaker; E Braunwald Journal: Circulation Date: 1998-09-01 Impact factor: 29.690
Authors: Paul M Ridker; Christopher P Cannon; David Morrow; Nader Rifai; Lynda M Rose; Carolyn H McCabe; Marc A Pfeffer; Eugene Braunwald Journal: N Engl J Med Date: 2005-01-06 Impact factor: 91.245
Authors: Abhiram Prasad; Mandeep Singh; Amir Lerman; Ryan J Lennon; David R Holmes; Charanjit S Rihal Journal: J Am Coll Cardiol Date: 2006-10-17 Impact factor: 24.094
Authors: D A Morrow; N Rifai; E M Antman; D L Weiner; C H McCabe; C P Cannon; E Braunwald Journal: J Am Coll Cardiol Date: 1998-06 Impact factor: 24.094
Authors: Issam D Moussa; Lloyd W Klein; Binita Shah; Roxana Mehran; Michael J Mack; Emmanouil S Brilakis; John P Reilly; Gilbert Zoghbi; Elizabeth Holper; Gregg W Stone Journal: J Am Coll Cardiol Date: 2013-10-22 Impact factor: 24.094