Assessment of Peri-procedural Myocardial Injury in Patients of Post-percutaneous Coronary Intervention: Diagnosis through Serum Biomarkers as Cardiac Troponin T and Creatine Kinase Myocardial Isoform

ABSTRACT

Background: Cardiac troponin (CTnT) and creatinine kinase myocardial isoform (CKMB) are suitable marker for myocardial injury following percutaneous coronary intervention (PCI). Elevation of these markers lead to major adverse cardiac events (MACEs). The objective was to detect the elevation of serum CTnT and CKMB during post-PCI period and identify MACE during six-month followed up among patients in eastern Indian. Methods: In present study, 100 patients were randomly selected for coronary angioplasty between April2012 to March2013. All the cases were referred to catheterization laboratory for elective PCI for single vessel or multivessel in native coronary artery. The CTnT and CKMB parameters were estimated as per standard protocol. The categorization was done on the basis of baseline (normal value), ≤3time and >3time elevation for both the biomarkers and respective MACEs as MACE-1, MACE-2, MACE-3, MACE-4 and MACE-5 were determined. Results: There were more MACE in patients in six month follow up who sustainned >3times elevation in CTnT and CKMB during pos-PCI period. There was highly significant correlation (P<0.001 and P<0.01) with increasing trend of CTnT and CKMB elevation and risk of MACEs. MACEs were significantly (P<0.001 and P<0.01) correlated with diabetes mellitus, hypertension, renal dysfunction, fluoroscopy time, stent length, left ventricular ejection fraction and type of lesion. It was also observed that more hospital stay led to elevation of CTnT and CKMB. Conclusions: It is concluded that the elevation of CTnT and CKMB in serum during post-PCI can predict MACEs in six-month follow up in stable ischaemic heart disease.