Post-procedural elevated cardiac troponin I and the association with 5-year mortality in patients undergoing elective...

Area of Science:

• Cardiology
• Biomarkers
• Interventional Cardiology

Background:

• The prognostic significance of cardiac troponin I (cTnI) thresholds post-percutaneous coronary intervention (PCI) remains debated.
• Establishing a clinically meaningful cTnI threshold is vital for long-term patient outcomes.

Purpose of the Study:

• To evaluate the association between various post-procedural cTnI levels and 5-year mortality.
• To identify a specific cTnI threshold predictive of long-term prognosis after elective PCI.

Main Methods:

• Analysis of 4059 patients with normal baseline cTnI undergoing elective PCI.
• Measurement of post-procedural cTnI levels between 8-48 hours after PCI.
• Assessment of 5-year all-cause and cardiovascular mortality as primary endpoints.

Main Results:

• A post-procedural cTnI ≥70 times the upper reference limit (URL) independently predicted 5-year all-cause and cardiovascular mortality.
• Higher peak cTnI levels correlated with increased mortality rates.
• The Society for Cardiovascular Angiography and Interventions (SCAI) 2014 threshold (≥70x URL) showed significant association with mortality.

Conclusions:

• A post-procedural cTnI level ≥70x URL is an independent predictor of 5-year mortality in patients undergoing elective PCI.
• The SCAI 2014 cTnI threshold is the most relevant for assessing long-term mortality risk in this population.