CARDIAC TROPONIN-T AND CK-MB MASS RELEASE AFTER VISUALLY SUCCESSFUL PERCUTANEOUS TRANSLUMINAR CORONARY ANGIOPLASTY IN STABLE ANGINA-PECTORIS

The incidence of cardiac troponin T (Tn-T) and creatine kinase (CK) is oenzyme MB mass release was studied in 23 patients with stable angina pectoris undergoing visually successful percutaneous transluminal coro nary angioplasty (PTCA). Serial blood samples were drawn for measureme nt of serum Tn-T, CK-MB mass, total CK activity, CK-MB activity, and l actate dehydrogenase isoenzyme (LD-1). ST segment monitoring was carri ed out during PTCA and for the following 24 hours. None of the patient s showed electrocardiographic (ECG) evidence of myocardial infarction. However, Tn-T was elevated in three patients (0.23 to 1.32 mu g/L), a nd in these three and an additional three patients CK-MB mass was also elevated (7.0 to 27.5 mu g/L). Total CK activity and LD-I were only e levated in one of these six patients. None had elevated CK-MB activity . ST segment depression on ECG recording was not predictive of Tn-T or CK-MB mass release. Patients with elevated Tn-T or CK-MB mass did not differ with respect to demographic data, stenosis characteristics, or in the PTCA procedure. We conclude that CK-MB mass uncovers clinicall y and ambulatory electrocardiographically inapparent severe myocardial ischemia/minor myocardial damage (microembolization) in 26% (6 of 23) of patients after visually successful PTCA; 13% (3 of 23) had elevate d Tn-T, indicating minor myocardial damage. The application of these m arkers in the future could be of considerable value for determining th e efficacy of coronary angioplasty and atherectomy, as well as for dru g therapy in connection with such procedures. (AM HEART J 1994;127:13- 20.)