Prognostic implication of cardiac troponin T increase following stent implantation

Joerg Herrmann, C. Von Birgelen, M. Haude, L. Volbracht, N. Malyar, H. Eggebrecht, T. F.M. Konorza, D. Baumgart, R. Erbel

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Objective: To identify the incidence and clinical significance of myocardial injury following elective stent implantation. Design: Prospective clinical study with 278 consecutive patients undergoing stenting of de novo coronary or saphenous vein graft lesions. Incidence of periprocedural myocardial injury was assessed by analysis of 12 lead ECG, creatine kinase (CK; upper limit of normal (ULN) 70 IU/I for women, 80 IU/I for men), and cardiac troponin T (cTnT; point of care test; threshold 0.1 ng/ml) before and 6, 12, and 24 hours after the intervention. Major adverse cardiac events (MACE: acute myocardial infarction, bypass surgery, and cardiac death) were recorded during clinical follow up (mean (SD) 7.8 (5.3) months). Results: Following elective stenting, the rate of a positive cTnT status was 17.3%, the rate of CK increase of 1-3x ULN 14.7%, the rate of CK increase of > 3x ULN 1.4%, and the rate of Q wave myocardial infarction 0.4%. Cardiac mortality during follow up was higher in patients with postprocedurally increased CK (7.1% v 1.3%, p = 0.01, log rank) and cTnT (9.1% v 0.9%, p < 0.001, log rank). In addition, postprocedurally increased cTnT was associated with a higher overall incidence of MACE (13.1% v 4.0%, p < 0.01, log rank) and was identified as an independent factor for MACE during follow up (hazard ratio 3.27, 95% confidence interval 1.14 to 9.41, p = 0.028). Conclusions: Following elective stent implantation, a positive cTnT status identified patients at risk of a worse long term outcome. Treatment strategies have to be developed that lead to prognostic improvement by reducing periprocedural myocardial injury.

Original languageEnglish (US)
Pages (from-to)549-553
Number of pages5
JournalHeart
Volume87
Issue number6
StatePublished - Jun 3 2002
Externally publishedYes

Fingerprint

Troponin T
Stents
Incidence
Wounds and Injuries
Point-of-Care Systems
Myocardial Infarction
Saphenous Vein
Creatine Kinase
Coronary Vessels
Electrocardiography
Prospective Studies
Confidence Intervals
Transplants
Mortality
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Herrmann, J., Von Birgelen, C., Haude, M., Volbracht, L., Malyar, N., Eggebrecht, H., ... Erbel, R. (2002). Prognostic implication of cardiac troponin T increase following stent implantation. Heart, 87(6), 549-553.

Prognostic implication of cardiac troponin T increase following stent implantation. / Herrmann, Joerg; Von Birgelen, C.; Haude, M.; Volbracht, L.; Malyar, N.; Eggebrecht, H.; Konorza, T. F.M.; Baumgart, D.; Erbel, R.

In: Heart, Vol. 87, No. 6, 03.06.2002, p. 549-553.

Research output: Contribution to journalArticle

Herrmann, J, Von Birgelen, C, Haude, M, Volbracht, L, Malyar, N, Eggebrecht, H, Konorza, TFM, Baumgart, D & Erbel, R 2002, 'Prognostic implication of cardiac troponin T increase following stent implantation', Heart, vol. 87, no. 6, pp. 549-553.
Herrmann J, Von Birgelen C, Haude M, Volbracht L, Malyar N, Eggebrecht H et al. Prognostic implication of cardiac troponin T increase following stent implantation. Heart. 2002 Jun 3;87(6):549-553.
Herrmann, Joerg ; Von Birgelen, C. ; Haude, M. ; Volbracht, L. ; Malyar, N. ; Eggebrecht, H. ; Konorza, T. F.M. ; Baumgart, D. ; Erbel, R. / Prognostic implication of cardiac troponin T increase following stent implantation. In: Heart. 2002 ; Vol. 87, No. 6. pp. 549-553.
@article{7ed6b6b9aef04dbb98bfc16060529402,
title = "Prognostic implication of cardiac troponin T increase following stent implantation",
abstract = "Objective: To identify the incidence and clinical significance of myocardial injury following elective stent implantation. Design: Prospective clinical study with 278 consecutive patients undergoing stenting of de novo coronary or saphenous vein graft lesions. Incidence of periprocedural myocardial injury was assessed by analysis of 12 lead ECG, creatine kinase (CK; upper limit of normal (ULN) 70 IU/I for women, 80 IU/I for men), and cardiac troponin T (cTnT; point of care test; threshold 0.1 ng/ml) before and 6, 12, and 24 hours after the intervention. Major adverse cardiac events (MACE: acute myocardial infarction, bypass surgery, and cardiac death) were recorded during clinical follow up (mean (SD) 7.8 (5.3) months). Results: Following elective stenting, the rate of a positive cTnT status was 17.3{\%}, the rate of CK increase of 1-3x ULN 14.7{\%}, the rate of CK increase of > 3x ULN 1.4{\%}, and the rate of Q wave myocardial infarction 0.4{\%}. Cardiac mortality during follow up was higher in patients with postprocedurally increased CK (7.1{\%} v 1.3{\%}, p = 0.01, log rank) and cTnT (9.1{\%} v 0.9{\%}, p < 0.001, log rank). In addition, postprocedurally increased cTnT was associated with a higher overall incidence of MACE (13.1{\%} v 4.0{\%}, p < 0.01, log rank) and was identified as an independent factor for MACE during follow up (hazard ratio 3.27, 95{\%} confidence interval 1.14 to 9.41, p = 0.028). Conclusions: Following elective stent implantation, a positive cTnT status identified patients at risk of a worse long term outcome. Treatment strategies have to be developed that lead to prognostic improvement by reducing periprocedural myocardial injury.",
author = "Joerg Herrmann and {Von Birgelen}, C. and M. Haude and L. Volbracht and N. Malyar and H. Eggebrecht and Konorza, {T. F.M.} and D. Baumgart and R. Erbel",
year = "2002",
month = "6",
day = "3",
language = "English (US)",
volume = "87",
pages = "549--553",
journal = "Heart",
issn = "1355-6037",
publisher = "BMJ Publishing Group",
number = "6",

}

TY - JOUR

T1 - Prognostic implication of cardiac troponin T increase following stent implantation

AU - Herrmann, Joerg

AU - Von Birgelen, C.

AU - Haude, M.

AU - Volbracht, L.

AU - Malyar, N.

AU - Eggebrecht, H.

AU - Konorza, T. F.M.

AU - Baumgart, D.

AU - Erbel, R.

PY - 2002/6/3

Y1 - 2002/6/3

N2 - Objective: To identify the incidence and clinical significance of myocardial injury following elective stent implantation. Design: Prospective clinical study with 278 consecutive patients undergoing stenting of de novo coronary or saphenous vein graft lesions. Incidence of periprocedural myocardial injury was assessed by analysis of 12 lead ECG, creatine kinase (CK; upper limit of normal (ULN) 70 IU/I for women, 80 IU/I for men), and cardiac troponin T (cTnT; point of care test; threshold 0.1 ng/ml) before and 6, 12, and 24 hours after the intervention. Major adverse cardiac events (MACE: acute myocardial infarction, bypass surgery, and cardiac death) were recorded during clinical follow up (mean (SD) 7.8 (5.3) months). Results: Following elective stenting, the rate of a positive cTnT status was 17.3%, the rate of CK increase of 1-3x ULN 14.7%, the rate of CK increase of > 3x ULN 1.4%, and the rate of Q wave myocardial infarction 0.4%. Cardiac mortality during follow up was higher in patients with postprocedurally increased CK (7.1% v 1.3%, p = 0.01, log rank) and cTnT (9.1% v 0.9%, p < 0.001, log rank). In addition, postprocedurally increased cTnT was associated with a higher overall incidence of MACE (13.1% v 4.0%, p < 0.01, log rank) and was identified as an independent factor for MACE during follow up (hazard ratio 3.27, 95% confidence interval 1.14 to 9.41, p = 0.028). Conclusions: Following elective stent implantation, a positive cTnT status identified patients at risk of a worse long term outcome. Treatment strategies have to be developed that lead to prognostic improvement by reducing periprocedural myocardial injury.

AB - Objective: To identify the incidence and clinical significance of myocardial injury following elective stent implantation. Design: Prospective clinical study with 278 consecutive patients undergoing stenting of de novo coronary or saphenous vein graft lesions. Incidence of periprocedural myocardial injury was assessed by analysis of 12 lead ECG, creatine kinase (CK; upper limit of normal (ULN) 70 IU/I for women, 80 IU/I for men), and cardiac troponin T (cTnT; point of care test; threshold 0.1 ng/ml) before and 6, 12, and 24 hours after the intervention. Major adverse cardiac events (MACE: acute myocardial infarction, bypass surgery, and cardiac death) were recorded during clinical follow up (mean (SD) 7.8 (5.3) months). Results: Following elective stenting, the rate of a positive cTnT status was 17.3%, the rate of CK increase of 1-3x ULN 14.7%, the rate of CK increase of > 3x ULN 1.4%, and the rate of Q wave myocardial infarction 0.4%. Cardiac mortality during follow up was higher in patients with postprocedurally increased CK (7.1% v 1.3%, p = 0.01, log rank) and cTnT (9.1% v 0.9%, p < 0.001, log rank). In addition, postprocedurally increased cTnT was associated with a higher overall incidence of MACE (13.1% v 4.0%, p < 0.01, log rank) and was identified as an independent factor for MACE during follow up (hazard ratio 3.27, 95% confidence interval 1.14 to 9.41, p = 0.028). Conclusions: Following elective stent implantation, a positive cTnT status identified patients at risk of a worse long term outcome. Treatment strategies have to be developed that lead to prognostic improvement by reducing periprocedural myocardial injury.

UR - http://www.scopus.com/inward/record.url?scp=0036099468&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036099468&partnerID=8YFLogxK

M3 - Article

C2 - 12010937

AN - SCOPUS:0036099468

VL - 87

SP - 549

EP - 553

JO - Heart

JF - Heart

SN - 1355-6037

IS - 6

ER -