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01-05-2007 | original article

Troponin T elevation and prognosis after multivessel compared with single-vessel elective percutaneous coronary intervention

Auteurs: M. B. Nienhuis, J. P. Ottervanger, H. E. Dambrink, L. D. Dikkeschei, H. Suryapranata, A. W. J. van ’t Hof, J. C. A. Hoorntje, M. J. de Boer, A. T. M. Gosselink, F. Zijlstra

Gepubliceerd in: Netherlands Heart Journal | Uitgave 5/2007

Abstract

Background. Although techniques for percutaneous coronary intervention (PCI) have improved, patients with PCI of more vessels may still have an increased risk. We performed a prospective observational study evaluating the differences between multivessel and single-vessel procedures according to postprocedural troponin T (TnT) elevation and events during follow-up.

Methods. The study included 713 patients without elevated TnT (<0.05 ng/ml) before PCI. Primary endpoint was the combined endpoint of death, myocardial infarction, stroke, repeat coronary angiography and readmission for anginal symptoms during the mean follow-up of 10.9 months.

Results. TnT after PCI was elevated in 150 patients (21%) and was significantly associated with an increased incidence of the primary endpoint (RR 1.55, 95% CI 1.01 to 2.38). PCI of more than one vessel was performed in 146 patients (20%). These patients more often had increased TnT levels after the procedure (31.5 vs. 18.3%, p=0.001) and an increased incidence of the primary endpoint during follow-up (28 vs. 19%, p=0.01). After multivariable analysis, multivessel PCI was a statistically significant predictor of postprocedural TnT increase (OR 1.90, 95% CI 1.17 to 3.06). Multivessel PCI was also associated with an increased risk of the primary endpoint (OR 1.73, 95% CI 1.18 to 2.52), but after adjusting for multivessel disease this association was not statistically significant (OR 1.42, 95% CI 0.92 to 2.19).

Conclusion. Elective PCI of more vessels in one session is, in comparison with single-vessel PCI, more often associated with postprocedural troponin T rise and a (nonsignificantly) higher incidence of cardiac events during follow-up. Whether staged PCI is associated with less morbidity has to be assessed. (Neth Heart J 2007;15:178-83.)

vorige artikel Emergency cardiac surgery after a failed percutaneous coronary intervention in an interventional centre without on-site cardiac surgery

volgende artikel Familial screening and genetic counselling in hypertrophic cardiomyopathy: the Rotterdam experience

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Titel: Troponin T elevation and prognosis after multivessel compared with single-vessel elective percutaneous coronary intervention
Auteurs: M. B. Nienhuis
J. P. Ottervanger
H. E. Dambrink
L. D. Dikkeschei
H. Suryapranata
A. W. J. van ’t Hof
J. C. A. Hoorntje
M. J. de Boer
A. T. M. Gosselink
F. Zijlstra
Publicatiedatum: 01-05-2007
Uitgeverij: Bohn Stafleu van Loghum
Gepubliceerd in: Netherlands Heart Journal / Uitgave 5/2007
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI: https://doi.org/10.1007/BF03085977

Bohn Stafleu van Loghum

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