Incidence, predictors and longer‐term impact of troponin elevation following hybrid chronic total occlusion percutaneous coronary intervention

摘要: OBJECTIVES We examined the incidence of periprocedural cardiac enzyme rise (PCER) [troponin T (TnT) or high-sensivity (hs)TnT >5× upper limit normal (ULN)] and myocardial infarction (PMI), predictors PCER impact on longer-term major adverse events (MACE) following hybrid chronic total occlusion (CTO) percutaneous coronary intervention (PCI). BACKGROUND PMI after CTO PCI, risk factors for its MACE are not fully understood. METHODS Among 469 PCI cases performed between 01/2010 12/2015, next-day TnT hsTnT was measured in 455 (97%). (with clinical context ≥70× ULN). In 269 successful who had measured, (death, MI target-vessel revascularisation/re-occlusion) were assessed. RESULTS Overall, 420 CTOs (92.3%) treated successfully. documented 34%, while 2.9%. By multivariable analyses, higher J-CTO score (OR = 1.3 per point; P = 0.002), lower creatinine clearance (OR = 1.01 each cc/min decrease; P < 0.0001) recent (OR = 2.4; P = 0.007) independent pre-PCI PCER. procedural variables, retrograde approach (OR = 1.9; P = 0.014) procedure duration (OR = 1.2 30 min; associated with At a median follow-up 396 days (9.3% vs. 8.1%; P = 0.60), predictor analysis. CONCLUSIONS is detected 1/3 patients. However, true occurs does predict long-term outcomes.