Résumé
To detect the minor myocardial injury in patients undergoing elective successful PTCA with and without stenting using Troponin- T [Tn- T] and CK-MB immuno- assay in stable angina pectoris.There is a controversy as to the source and significance of mild elevation of creatine kinase isoenzyme MB activity [CK - MB] and myoglobin in patient undergoing successful PTCA. While, cardiac troponin-T is a unique myocardial antigen that is released in circulation during ischemia it can be readily differentiated from the skeletal muscle isoform. Increase of Tn-T may occur for a variety of reasons in PTCA with stenting. So, Tn-T and CK-MB assay had proved useful as a diagnostic tools in detecting minor ischemic myocardial damage in unstable angina pectoris.40 patients with stable angina pectoris were arranged in two groups; group I; 20 patients [17 M and 3 F] underwent PTCA only, and group II; 20 patients [18 M and 2F] underwent PTCA with stenting. Excluded from the study are patients with: AMI, unstable angina, elevated cardiac enzymes before cardiac catheterization, other cardiacvascular diseases [valvular, cardiomyopathy, and pericardial diseases], conduction defect [RBBB, LBBB and third degree heart block], and pace rhythm.The selected patients [40] were subjected to; history taking clinical examination, 12 leads resting ECG, echo-Doppler examination, laboratory investigations, chest x-ray and cardiac catheterization for angiography and PTCA [with or without stenting]. Total CK, CK- MB and LDH were measured before and every 6 hours after PTCA for 24 hours. Tn- T was measured before, 6 hours and 24 hours after PTCA. Total CK was elevated in 12.5% in patients of both groups; it was elevated by 15% in group I versus 10% in group II. Patients with elevated total CK had elevated Tn-T [40%]. CK-MB was elevated by 10% of patients in both groups, it was elevated in 3 patients [15%] in group I and in one patient [5%] in group II, all patients with elevated CK-MB had elevated Tn-T [100%]