Coronary artery diseaseRelation of Troponin I Levels Following Nonemergent Percutaneous Coronary Intervention to Short- and Long-Term Outcomes
Section snippets
Methods
All patients undergoing PCI at the New York Presbyterian Hospital, Weill Cornell Medical College (New York, New York) are enrolled in the Cornell Angioplasty Registry. A standard case-report form delineating comprehensive patient demographics, preintervention clinical status, procedural findings, and in-hospital complications is completed for each PCI performed. Immediate and in-hospital events are recorded. Patient follow-up is obtained by publicly available mortality data through the Social
Results
There were 3,611 PCIs performed in 2,504 consecutive patients undergoing urgent or elective PCI during the defined period. Of these, 693 patients had increased baseline cTnI, 227 had increased baseline CK-MB, and 496 had increased CK-MB level after PCI. The remaining 1,601 patients were included in the final analysis. There were 831 patients (51.9%) with increased cTnI levels (median 0.20 ng/ml, mean ± SD 0.55 ± 1.7 ng/ml) after PCI. The distribution of patients with increased cTnI levels
Discussion
This study represents a contemporary evaluation of short- and long-term outcomes in patients with normal cTnI and CK-MB before PCI and normal CK-MB levels after nonemergent PCI. There are several major findings in the present study of patients with normal baseline cTnI: (1) an isolated increase in cTnI after PCI occurs very commonly in ∼50% of patients; (2) patients with an isolated increase in cTnI after elective PCI are at very low risk for adverse in-hospital cardiac events; (3) an increase
Acknowledgment
We acknowledge several limitations in this study. First, our analysis was derived from a single high-volume tertiary care center population. Second, although data in the present study were collected prospectively, this is a retrospective analysis and is subject to the limitations of such analyses. Third, independent core angiographic laboratory analysis of baseline and postprocedural angiograms was not performed, which may have provided additional procedural information about predictors of cTnI
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