Impact on Long-term Adverse Cardiac Events of Troponin T or Creatine Kinase-MB Release after Percutaneous Transluminal Coronary Angioplasty.
10.4070/kcj.2002.32.11.949
- Author:
Byung Ryul CHO
1
;
Kyung Pyo HONG
;
Hyeon Cheol GWON
;
Ji Dong SUNG
;
Sang Hoon LEE
;
Jeong Euy PARK
;
Jung Don SEO
;
Won Ro LEE
;
Suk Koo CHOI
Author Information
1. Department of Internal Medicine, Kangwon National University College of Medicine, Kangwondo, Korea.
- Publication Type:Original Article
- Keywords:
Angioplasty;
transluminal;
percutaneous coronary;
Creatine kinase;
Myocardial infarction;
Troponin T.
- MeSH:
Angina, Unstable;
Angioplasty;
Angioplasty, Balloon, Coronary*;
Coronary Occlusion;
Creatine Kinase;
Creatine*;
Follow-Up Studies;
Humans;
Incidence;
Myocardial Infarction;
Trinitrotoluene;
Troponin T*;
Troponin*
- From:Korean Circulation Journal
2002;32(11):949-957
- CountryRepublic of Korea
- Language:Korean
-
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 (>or=16 U/L) and/or TnT (>or=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 significantly influence on late MACE.
