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. 2016 Jan-Feb;68(1):57-62.
doi: 10.1016/j.ihj.2015.06.034. Epub 2016 Jan 18.

Multimarker risk stratification approach and cardiovascular outcomes in patients with stable coronary artery disease undergoing elective percutaneous coronary intervention

Vimal Mehta  1 , Rishi Sukhija  2 , Pratishtha Mehra  1 , Anuj Goyal  1 , Jamal Yusuf  1 , Bhawna Mahajan  3 , V K Gupta  3 , Sanjay Tyagi  1 , Chandrasekar Palaniswamy  4 , Wilbert S Aronow  5
Affiliations

Multimarker risk stratification approach and cardiovascular outcomes in patients with stable coronary artery disease undergoing elective percutaneous coronary intervention

Vimal Mehta et al. Indian Heart J. 2016 Jan-Feb.

Abstract

Aims: We studied the utility of multimarker risk stratification approach to predict cardiovascular outcomes in patients with stable coronary artery disease, undergoing elective percutaneous coronary intervention (PCI).

Methods: We prospectively evaluated 302 consecutive patients with stable coronary artery disease and normal CPK-MB and cardiac troponin T levels, and who underwent elective PCI at our institution. The following cardiac biomarkers were measured before and between 12 and 24h post-procedure: CK-MB, cardiac troponin T, hs-CRP, and NT-ProBNP. Patients were followed up for a minimum of 6 months.

Results: Post-PCI, CPK-MB levels were elevated but below myocardial infarction (MI) range in 70 patients (23%), and in the MI range in 6 patients (2%). Troponin T levels were detectable but below the 99th percentile (microleak) in 32 patients (10.6%) and elevated above the 99th percentile (periprocedural MI) in 104 patients (34.4%). At 9 months' follow-up, 1% died, 2% had stable angina, 10.3% had non-fatal MI, and 87.7% remained asymptomatic. There was no significant difference in clinical events among groups stratified by elevation of one biomarker or multiple biomarkers.

Conclusion: Single or multiple biomarker strategy in patients with normal baseline biomarkers failed to predict major cardiac events after PCI over medium-term follow-up.

Keywords: Biomarkers; Major adverse cardiovascular event; Percutaneous coronary intervention; Periprocedural myocardial infarction.

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Figures

Fig. 1
Fig. 1
Categories of post-PCI troponin level elevations. PCI, percutaneous coronary intervention; MI, myocardial infarction.
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