Elevations of troponin I after interventional cardiac catheterization

Area of Science:

• Pediatric Cardiology
• Biomarkers of Cardiac Injury
• Interventional Cardiology

Background:

• Cardiac troponin I (cTnI) is a specific serum marker for myocardial injury.
• Cardiac catheterization is a common procedure in pediatric patients.
• The potential for cTnI elevation post-procedure in children is not well-established.

Purpose of the Study:

• To determine if cardiac catheterization is associated with an increase in serum cardiac troponin I levels in children.
• To assess the temporal pattern of cTnI elevation after cardiac catheterization.

Main Methods:

• Serum samples collected from pediatric patients (<21 years) before, immediately after, and six hours post-cardiac catheterization.
• Cardiac troponin I levels measured using the Abbott AxSYM microparticle immunoassay.
• Patients with elevated baseline cTnI were excluded; normal levels defined as 0-0.4 ng/ml.

Main Results:

• Elevated serum cTnI levels observed in 79% of patients immediately after catheterization (p < 0.0001).
• Elevations persisted, with 86% showing elevated cTnI six hours post-procedure (p < 0.0001).
• Only two patients experienced complications potentially causing myocardial injury.

Conclusions:

• Cardiac catheterization is associated with a high proportion of serum cTnI elevations in children.
• These cTnI elevations are detectable immediately and sustained for at least six hours post-procedure.
• The findings suggest cardiac catheterization, particularly interventions, can cause myocardial injury even without overt complications.