High levels of troponin T or I, termed as cTnT or cTnI respectively, in patients who underwent angioplasty might suggest an increased risk of mortality and the development of other heart events such as heart attack. To improve the post-operative outcome, routine monitoring of these protein levels is recommended, especially after percutaneous coronary intervention (PCI).
Every year, more than one million Americans go through coronary angioplasty procedures. Angioplasty is indicated for patients with blocked heart arteries to improve the blood flow to the heart. Among patients who underwent elective PCI cases, around 30% showed subtle elevations in some cardiac enzymes, such as creatine kinase muscle-brain, or CK-MB. This is linked to an increase in nosocomial adverse heart events. Higher elevations of CK-MB also increase the risk for all-cause mortality.
The team of researchers conducted searches of published studies that reported the effects of cTnT or cTnI elevation after angioplasty. Findings revealed that cTnT or cTnI levels were quite high in 26% and 34% of patients, respectively. Furthermore, patients with high cardiac troponin levels had a 5.8% mortality rate, compared to the 4.4% rate in patients with no post-operative troponin elevations.
“Our analysis demonstrates that post-procedural elevation of cTnT or cTnI provides long-term prognostic information regarding mortality or myocardial infarction,” explained Dr. Dmitriy Feldman from the New York Presbyterian Hospital and Weill Cornell Medical College. “Routine monitoring of peri-procedural cTn levels and more intensive outpatient monitoring and treatment of patients with cTn elevations following elective PCI may help to improve long-term adverse outcomes in these patients.”
The study was published online in Catheterization and Cardiovascular Interventions, which is maintained by The Society for Cardiovascular Angiography and Interventions (SCAI).