Prognostic value of troponin T after elective percutaneous coronary intervention

Cardiac troponin T [cTnT] is a sensitive and specific marker of myocardial necrosis. Prognostic significance of isolated minor elevations of cTnT is a matter of debate .The aim of this study was to assess the impact of minor elevations of cTnT on major adverse cardiac events [MACE] following percutaneous coronary intervention [PCI]. We measured cTnT levels before and after PCI and evaluated the outcomes of 112 patients with normal baseline cTnT and complex coronary artery disease who required nonemergency PCI. Elevations [more than 0.03ng/ml] in cTnT were seen in 39 patients [34.8%].The angiographic characteristics of patients with increased cTnT levels had borderline differences compared to those with normal post PCI cTnT levels. Over a mean follow-up duration of 22 months, myocardial infarction [p<0.01] and the combined rate of death, myocardial infarction and revascularization [p<0.001] were significantly higher in patients with increased levels of post PCI cTnT. Estimated 22-month MACE-free survival for patients with increased and normal cTnT levels were 66.7% and 93.2%, respectively. Isolated minor elevations in cTnT after elective PCI in complex coronary lesions affect long-term prognosis regarding death, myocardial infarction and the need for repeated revascularization procedures

[Long-term clinical outcome after implantation of second-generation bare-metal stents]

Coronary artery Stenting is known to improve the outcome for ischemic heart disease. Many clinical studies have been performed to determine the long-term outcome of coronary Stenting and most of them were based on first-generation bare-metal Stents. The aim of this study is to evaluate long-term [24 +/- 6.4 month] results of second-generation bare metal stent. From August 2004 to September 2006, one hundred and twenty eight [128] consecutive patients with significant coronary artery stenosis underwent elective angioplasty and stent implantation, using second generation bare metal stent [BMS]. Clinical outcome were analyzed after [24 +/- 6.4] months. The Primary end point was based on the incidence of MACE [MI, Death, and Repeat Revascularization]. One hundred and forty four [144] bare metal stents were implanted in 134 Vessels. The Mean age was 57 +/- 10.4 years, 72% of patients were male and 35.2% were diabetic with 98.4% in- patient hospitalization success rate. Thirteen [10.3%] patients had MACE during the follow-up period [4MI, 3CABG, 2 Deaths and 4R-PCI]. Independent Predictor of MACE was Unstable Angina, Prior PCI, Prior CABG, stent diameter and post PCI plavix dose. Our study demonstrated second generation bare metal stent, is superior to the first generation one with a greater survival rate and lower incidence of MACE