The impact of micro troponin leak on long-term outcomes following elective percutaneous coronary intervention.

摘要: Objective: To evaluate the clinical impact of microleaks troponin, which are below reference standard defining troponin elevation, on cardiovascular outcomes in stable coronary patients undergoing elective percutaneous intervention (PCI). Background: Troponin either pre- or post-PCI, has been shown to predict poor outcomes. However, measurements that above limit detection but 99th percentile elevation (‘‘microleak’’) have uncertain significance. Methods: We assessed subsequent myocardial infarction (MI) and death over a mean follow-up 4.2 years 2,272 PCI, where baseline troponins were normal obtained 12–24 hr post-PCI. Patients divided into three groups based post-PCI levels: Group 1 (n 5 1,313) nondetectable; group 2 587) microleak, 3 372) elevated suggesting necrosis. Results: The combined endpoint MI was similar (50.3 vs. 51.9%, respectively, P NS), significantly more than (35.6%, < 0.01) period. Multivariate analysis demonstrated microleak an independent predictor (P 0.01). Conclusions: Microleak following PCI suggests injury predicts increased risk death. Troponins should be routinely preventive therapies needed reduce micro macro setting. V C 2009 Wiley-Liss, Inc.