• Sirikarn Napan, Ramesh Chillal Kashinath, Sameer Kadri, Maria N Orig, and Suhail Khadra.
• Division of Cardiology, Department of Internal Medicine, Howard University Hospital, Washington, DC 20060, USA. snapan@howard.edu
• Coron. Artery Dis. 2010 Aug 1;21(5):261-5.

ObjectiveCardiac troponin elevation has been shown to be associated with adverse outcomes after percutaneous coronary intervention (PCI) for various subgroups of coronary artery disease. We sought to determine the prognostic significance of cardiac troponin I (cTnI) in patients with non-ST-elevation acute coronary syndromes (NSTE-ACS) treated with PCI.MethodsThe study consisted of 760 consecutive patients undergoing PCI for NSTE-ACS. Levels of cTnI were obtained repeatedly every 6 h before PCI. Peak cTnI levels were used for analysis. Patients were followed for major adverse cardiac events (MACE) defined as death, myocardial infarction, and urgent target vessel revascularization for a mean follow-up of 2.9 years.ResultsPatients with normal cTnI levels (20 ng/ml). By multivariate analyses, patients with higher peak preprocedural cTnI levels were independently associated with increased risk of 30-day mortality [adjusted odds ratio, 1.88, 95% confidence interval (CI): 1.11-3.17, P=0.019] and composite MACE [group 1 vs. group 2 (adjusted hazard ratio 2.09, 95% CI: 1.35-3.23, P<0.001), group 1 vs. group 3 (adjusted hazard ratio 3.64, 95% CI: 2.39-5.56, P<0.001)].ConclusionPreprocedural cTnI level is a strong and independent predictor of 30-day mortality and long-term MACE after PCI in the setting of NSTE-ACS.

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