Troponin I elevation and cardiac events after percutaneous coronary intervention

Am Heart J. 2003 Mar;145(3):522-8. doi: 10.1067/mhj.2003.2.


Background: Serum troponins are sensitive markers of myonecrosis and ischemia and are now widely used in clinical practice. Although percutaneous coronary intervention (PCI)-related creatine kinase-myocardial band isoenzyme (CK-MB) elevation has been associated with future cardiac events, the significance of troponin elevation in this setting is unknown. We sought to determine whether serum troponin I (Tn-I) elevation after PCI is associated with future cardiac events. Methods and Results Consecutive patients undergoing elective PCI underwent systematic postprocedure measurement of Tn-I and CK-MB levels. Serum levels were correlated with demographic, angiographic, and procedural characteristics and the development of major adverse cardiac events (MACE; defined as death, MI, or need for PCI or coronary bypass graft surgery) at 30 days, 6 months, and 1 year. In 286 consecutive procedures, postintervention myonecrosis-specific Tn-I was elevated in 13.6% of patients, and CK-MB was elevated in 12.9% of patients. Multivariable predictors of Tn-I elevation were procedural side branch occlusion and thrombus formation. Peak Tn-I and CK-MB values were well correlated (r = 0.81, P <.0001). Three-fold elevation of Tn-I after successful PCI was independently predictive of MACE (P =.01).

Conclusions: Tn-I elevation after elective PCI is relatively common and is associated with procedural complications such as incidental side branch occlusion and thrombus formation. In addition, this study demonstrates that a 3-fold elevation of Tn-I after successful elective PCI is predictive of future cardiac events, especially the need for early repeat revascularization.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angina Pectoris / blood
  • Angina Pectoris / diagnosis
  • Angioplasty, Balloon, Coronary* / mortality
  • Biomarkers / blood
  • Coronary Angiography
  • Coronary Artery Bypass
  • Coronary Disease / blood
  • Coronary Disease / surgery
  • Coronary Disease / therapy*
  • Creatine Kinase / blood*
  • Creatine Kinase, MB Form
  • Female
  • Humans
  • Isoenzymes / blood*
  • Male
  • Middle Aged
  • Myocardial Infarction / blood
  • Myocardial Infarction / diagnosis*
  • Myocardial Ischemia / blood
  • Myocardial Ischemia / diagnosis
  • Prospective Studies
  • Time Factors
  • Treatment Outcome
  • Troponin T / blood*


  • Biomarkers
  • Isoenzymes
  • Troponin T
  • Creatine Kinase
  • Creatine Kinase, MB Form