Prognostic Value of Troponin T after Elective Percutaneous Coronary Intervention

Background: Cardiac troponin T (cTnT) is a sensitive and specific marker of myocardial necrosis. Prognostic significance of isolated minor elevations of cTnT is a matter of debate. The aim of this study was to assess the impact of minor elevations of cTnT on major adverse cardiac events (MACE) following percutaneous coronary intervention (PCI). Methods: We measured cTnT levels before and after PCI and evaluated the outcomes of 112 patients with normal baseline cTnT and complex coronary artery disease who required nonemergency PCI. Results: Elevations (more than 0.03ng/ml) in cTnT were seen in 39 patients (34.8%). The angiographic characteristics of patients with increased cTnT levels had borderline differences compared to those with normal post PCI cTnT levels. Over a mean follow-up duration of 22 months, myocardial infarction (p<0.01) and the combined rate of death, myocardial infarction and revascularization (p<0.001) were significantly higher in patients with increased levels of post PCI cTnT. Estimated 22-month MACE-free survival for patients with increased and normal cTnT levels were 66.7% and 93.2%, respectively Conclusions: Isolated minor elevations in cTnT after elective PCI in complex coronary lesions affect long-term prognosis regarding death, myocardial infarction and the need for repeated revascularization procedures.