Prognostic value of troponin after elective percutaneous coronary intervention: A meta-analysis

Catheter Cardiovasc Interv. 2008 Feb 15;71(3):318-24. doi: 10.1002/ccd.21345.

Abstract

Background: Although the prognostic importance of troponin in patients with anacute coronary syndrome is clear, the significance of troponin elevation after elective percutaneous coronary intervention (PCI) is a subject of debate. However, most studies up to now had a small sample size and insufficient events during follow-up.

Methods: Electronic and manual searches were performed of studies reporting on prognosis of troponin after elective PCI. A meta-analysis was done of all suitable studies, with death in follow-up as primary endpoint and the combination of death or nonfatal myocardial infarction in follow-up as secondary endpoint.

Results: 20 studies involving 15,581 patients were included. These studies were published between 1998 and 2007. Overall, troponin was elevated after elective PCI in 32.9% of patients. The follow-up period varied between 3 and 67 months (mean 16.3). Increased mortality was significantly associated with troponin elevation after PCI (4.4% vs. 3.3%, P = 0.001; OR 1.35). Furthermore, the combined endpoint of mortality or nonfatal myocardial infarction also occurred more often in patients with post-procedural troponin elevation (8.1% vs. 5.2%, P < 0.001; OR 1.59).

Conclusions: According to this meta-analysis, troponin elevation after elective PCI provides important prognostic information.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Angioplasty, Balloon, Coronary / methods*
  • Angioplasty, Balloon, Coronary / mortality
  • Biomarkers / blood
  • Cohort Studies
  • Coronary Angiography
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / enzymology*
  • Coronary Stenosis / mortality*
  • Coronary Stenosis / therapy
  • Creatine Kinase, MB Form / blood*
  • Creatine Kinase, MB Form / metabolism
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Male
  • Meta-Analysis as Topic
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Retrospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Survival Analysis
  • Treatment Outcome
  • Troponin T / blood*
  • Troponin T / metabolism

Substances

  • Biomarkers
  • Troponin T
  • Creatine Kinase, MB Form