Significance of elevated cardiac troponin after percutaneous coronary interventions

Assays for cardiac troponin have become a standard for the diagnosis of myocardial damage. Due to their high sensitivity, minor myocardial injury can be frequently detected following percutaneous coronary interventions (PCI). Minor elevations in cardiac enzymes after apparently successful PCI are rather common and even modest increases in creatine kinase myocardial band (CK-MB) elevation identify a population with worse long-term prognosis compared to patients with no enzyme elevation. The significance of troponin elevation in acute coronary syndromes and its prognostic implications on short- and long-term clinical outcomes were previously demonstrated in several clinical studies. Conversely, data regarding troponin elevation after an apparently successful PCI is limited and their relevance in terms of predicting clinical outcomes remains unclear. Given the higher sensitivity of troponin essays, the incidence of troponin elevation after PCI is higher than that of CK-MB. In this review we discuss the significance and implications of post-procedural troponin elevation.