Below normal pre-procedural cardiac troponin i levels are associated with an adverse prognosis after percutaneous coronary interventions

Alessandro Lupi, Andrea Rognoni, Maurizio Lazzero, Roberta Rolla, Patrizia Pergolini, Giorgio Bellomo, Lidia Rossi, Angelo Sante Bongo, Allan S Jaffe

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Abstract

Aims: To evaluate the prognostic implications of baseline cardiac troponin (cTn) values in the normal range in stable coronary artery disease (CAD) patients successfully treated with percutaneous coronary intervention (PCI). Methods and results: We investigated the correlation between pre-procedural cTnI levels and major clinical adverse events at three years of follow-up in 1,063 consecutive stable CAD patients with normal baseline cTnI levels, successfully treated with PCI. Patients with pre-procedural cTnI levels in the upper tertile showed an increased long-Term risk of overall death (HR 3.17, 95% CI: 1.62 to 6.21; p=0.0001), cardiac death (HR 5.09, 95% CI: 2.30 to 11.25; p=0.002), myocardial infarction (MI) (HR 2.34, 95% CI: 1.45 to 3.76; p=0.003) and target vessel failure (TVF) (HR 1.91, 95% CI: 1.28 to 2.84; p=0.006). Pre-procedural cTnI levels remained significantly correlated after adjustment for clinical and angiographic findings. Analysis of pre-PCI values eliminated any association of post-PCI values with prognosis. Conclusions: In stable CAD patients successfully treated with PCI, pre-procedural cTnI levels, in the upper limits of the normal range, are associated with hard cardiac endpoints.

Original languageEnglish (US)
Pages (from-to)1380-1388
Number of pages9
JournalEuroIntervention
Volume11
Issue number12
DOIs
StatePublished - Mar 1 2016

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Troponin
Percutaneous Coronary Intervention
Coronary Artery Disease
Reference Values
Myocardial Infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Below normal pre-procedural cardiac troponin i levels are associated with an adverse prognosis after percutaneous coronary interventions. / Lupi, Alessandro; Rognoni, Andrea; Lazzero, Maurizio; Rolla, Roberta; Pergolini, Patrizia; Bellomo, Giorgio; Rossi, Lidia; Bongo, Angelo Sante; Jaffe, Allan S.

In: EuroIntervention, Vol. 11, No. 12, 01.03.2016, p. 1380-1388.

Research output: Contribution to journalArticle

Lupi, Alessandro ; Rognoni, Andrea ; Lazzero, Maurizio ; Rolla, Roberta ; Pergolini, Patrizia ; Bellomo, Giorgio ; Rossi, Lidia ; Bongo, Angelo Sante ; Jaffe, Allan S. / Below normal pre-procedural cardiac troponin i levels are associated with an adverse prognosis after percutaneous coronary interventions. In: EuroIntervention. 2016 ; Vol. 11, No. 12. pp. 1380-1388.
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abstract = "Aims: To evaluate the prognostic implications of baseline cardiac troponin (cTn) values in the normal range in stable coronary artery disease (CAD) patients successfully treated with percutaneous coronary intervention (PCI). Methods and results: We investigated the correlation between pre-procedural cTnI levels and major clinical adverse events at three years of follow-up in 1,063 consecutive stable CAD patients with normal baseline cTnI levels, successfully treated with PCI. Patients with pre-procedural cTnI levels in the upper tertile showed an increased long-Term risk of overall death (HR 3.17, 95{\%} CI: 1.62 to 6.21; p=0.0001), cardiac death (HR 5.09, 95{\%} CI: 2.30 to 11.25; p=0.002), myocardial infarction (MI) (HR 2.34, 95{\%} CI: 1.45 to 3.76; p=0.003) and target vessel failure (TVF) (HR 1.91, 95{\%} CI: 1.28 to 2.84; p=0.006). Pre-procedural cTnI levels remained significantly correlated after adjustment for clinical and angiographic findings. Analysis of pre-PCI values eliminated any association of post-PCI values with prognosis. Conclusions: In stable CAD patients successfully treated with PCI, pre-procedural cTnI levels, in the upper limits of the normal range, are associated with hard cardiac endpoints.",
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T1 - Below normal pre-procedural cardiac troponin i levels are associated with an adverse prognosis after percutaneous coronary interventions

AU - Lupi, Alessandro

AU - Rognoni, Andrea

AU - Lazzero, Maurizio

AU - Rolla, Roberta

AU - Pergolini, Patrizia

AU - Bellomo, Giorgio

AU - Rossi, Lidia

AU - Bongo, Angelo Sante

AU - Jaffe, Allan S

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N2 - Aims: To evaluate the prognostic implications of baseline cardiac troponin (cTn) values in the normal range in stable coronary artery disease (CAD) patients successfully treated with percutaneous coronary intervention (PCI). Methods and results: We investigated the correlation between pre-procedural cTnI levels and major clinical adverse events at three years of follow-up in 1,063 consecutive stable CAD patients with normal baseline cTnI levels, successfully treated with PCI. Patients with pre-procedural cTnI levels in the upper tertile showed an increased long-Term risk of overall death (HR 3.17, 95% CI: 1.62 to 6.21; p=0.0001), cardiac death (HR 5.09, 95% CI: 2.30 to 11.25; p=0.002), myocardial infarction (MI) (HR 2.34, 95% CI: 1.45 to 3.76; p=0.003) and target vessel failure (TVF) (HR 1.91, 95% CI: 1.28 to 2.84; p=0.006). Pre-procedural cTnI levels remained significantly correlated after adjustment for clinical and angiographic findings. Analysis of pre-PCI values eliminated any association of post-PCI values with prognosis. Conclusions: In stable CAD patients successfully treated with PCI, pre-procedural cTnI levels, in the upper limits of the normal range, are associated with hard cardiac endpoints.

AB - Aims: To evaluate the prognostic implications of baseline cardiac troponin (cTn) values in the normal range in stable coronary artery disease (CAD) patients successfully treated with percutaneous coronary intervention (PCI). Methods and results: We investigated the correlation between pre-procedural cTnI levels and major clinical adverse events at three years of follow-up in 1,063 consecutive stable CAD patients with normal baseline cTnI levels, successfully treated with PCI. Patients with pre-procedural cTnI levels in the upper tertile showed an increased long-Term risk of overall death (HR 3.17, 95% CI: 1.62 to 6.21; p=0.0001), cardiac death (HR 5.09, 95% CI: 2.30 to 11.25; p=0.002), myocardial infarction (MI) (HR 2.34, 95% CI: 1.45 to 3.76; p=0.003) and target vessel failure (TVF) (HR 1.91, 95% CI: 1.28 to 2.84; p=0.006). Pre-procedural cTnI levels remained significantly correlated after adjustment for clinical and angiographic findings. Analysis of pre-PCI values eliminated any association of post-PCI values with prognosis. Conclusions: In stable CAD patients successfully treated with PCI, pre-procedural cTnI levels, in the upper limits of the normal range, are associated with hard cardiac endpoints.

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