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High-sensitivity cardiac troponin decrease after percutaneous coronary intervention in patients with stable coronary artery disease

Heart and Vessels volume 34, pages 948–956 (2019)Cite this article

Abstract

Baseline cardiac troponin is a strong predictor of major adverse cardiac events (MACE), and the high sensitive assay can provide risk stratification under the 99th percentile values. Currently, prognostic benefit of PCI has not been established in patients with stable coronary artery disease (CAD), and the influence on baseline troponin levels is unknown. This study aimed to investigate the impact of PCI on baseline high-sensitivity cardiac troponin-I (hs-cTnI) levels and the association with MACE incidence. For 401 patients with stable CAD who were indicated for PCI, baseline hs-cTnI levels were measured before PCI for two times (the average: pre-PCI hs-cTnI) and 10 months after PCI (post-PCI remote hs-cTnI). Hs-cTnI day-to-day variability was assessed based on the pre-PCI values and patients were divided into three groups (Increase/No change/Decrease group) according to the extent of hs-cTnI change (post-PCI remote hs-cTnI minus pre-PCI hs-cTnI) considering the day-to-day variability. A total of 77 patients were categorized into Decrease group. Although Decrease group had significantly higher pre-PCI hs-cTnI levels compared to the other groups, this group had lowest incidence of MACE (p < 0.001). Hs-cTnI changes were independently associated with MACE incidence after adjustment (HR 2.069, 95% CI 1.032–4.006, p = 0.041 for Increase group vs. No change group; HR 0.143, 95% CI 0.008–0.680, p = 0.009 for Decrease group vs. No change group). Hs-cTnI change following PCI was significantly predicted by pre-PCI hs-cTnI, hs-cTnI variability, the presence of dyslipidemia, multivessel disease, and lesions with chronic total occlusion or low quantitative flow ratio. In conclusion, PCI could lower hs-cTnI levels in a certain subset of patients, in whom prognostic benefit might be expected by the intervention.

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Acknowledgements

We thank all the physicians, nurses, other catheter laboratory staff members, and patients involved in this study.

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Affiliations

  1. Division of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, 4-1-1, Otsuno, Tsuchiura, Ibaraki, Japan

    Rikuta Hamaya, Tomoki Horie, Akinori Sugano, Yoshihisa Kanaji, Eisuke Usui, Masahiro Hoshino, Masao Yamaguchi, Hiroaki Ohya, Yohei Sumino, Masahiro Hada, Hidenori Hirano, Yoshinori Kanno, Haruhito Yuki & Tsunekazu Kakuta

  2. Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan

    Taishi Yonetsu & Kenzo Hirao

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  1. Rikuta Hamaya
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  2. Tomoki Horie
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  3. Taishi Yonetsu
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  4. Akinori Sugano
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  5. Yoshihisa Kanaji
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  7. Masahiro Hoshino
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  8. Masao Yamaguchi
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  9. Hiroaki Ohya
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  12. Hidenori Hirano
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  13. Yoshinori Kanno
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  15. Kenzo Hirao
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  16. Tsunekazu Kakuta
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Correspondence to Tsunekazu Kakuta.

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Hamaya, R., Horie, T., Yonetsu, T. et al. High-sensitivity cardiac troponin decrease after percutaneous coronary intervention in patients with stable coronary artery disease. Heart Vessels 34, 948–956 (2019). https://doi.org/10.1007/s00380-018-01325-6

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  • DOI: https://doi.org/10.1007/s00380-018-01325-6

Keywords

  • Percutaneous coronary intervention
  • High-sensitivity cardiac troponin
  • Stable coronary artery disease
  • Multivessel disease
  • Quantitative flow ratio