[Isolated elevation of troponin-T level after percutaneous coronary interventions: clinical significance]

Relationship between isolated elevation of troponin-T (Tn-T) level after percutaneous coronary interventions (PCI) and remote outcomes was studied in 124 patients with ischemic heart disease with normal level of creatine kinase MB fraction after elective PCI. Blood samples for measurement of markers of myocardial necrosis were taken before, and in 8 and 24 hours after PCI. Patients were divided into 2 groups: without (n=58, group 1) and with (n=54, group 2) postprocedural elevation of Tn-T level above upper limit of normal ( more or equal 0.03 hg/ml). During follow-up we registered primary end points (cardiac deaths, nonfatal myocardial infarctions [MI]) and composite criterion comprising first occurrence of either of these outcomes. We also assessed 1, 2, 3, 4 and 5 year survival. There were no inhospital deaths and no significant differences between groups in rate of nonfatal MI (2 vs 0%) and occurrence of composite criterion (2 vs 0%). During long term follow-up Tn-T elevation also was not associated with increased number of deaths. However nonfatal MIs were more frequent and risk of death/MI higher in group 2 compared with group 1(6.5 vs 9.3%, p>0.05 and 15.5 vs 16.7%; p>0.05, respectively). Five year survival of patients with elevated Tn-T was not lower compared with patients of group 1.