CARDIAC TROPONIN-T, CREATINE-KINASE, AND ITS ISOFORM RELEASE AFTER SUCCESSFUL PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY WITH OR WITHOUT STENTING

Background Cardiac troponin T is a sensitive and specific marker for t he detection of minor myocardial injury. However, it has been rarely u sed to monitor myocardial injury after coronary stenting. The purpose of the study was to measure troponin T after apparently successful per cutaneous transluminal coronary angioplasty (PTCA) with or without cor onary stenting and to compare its result with serum creatine kinase an d its isoform, CKMB. Methods The incidence of cardiac troponin T eleva tion was compared with that of creatine kinase or CKMB in 120 consecut ive patients with symptomatic ischemia undergoing visually successful PTCA with (n = 59) or without stenting (n = 61). Troponin T, creatine kinase, and CKMB were measured before, immediately after, and 18 to 24 hours after the procedures were performed. Results No patient had abn ormal troponin T, creatine kinase, or CKMB levels before and immediate ly after the procedures. Moreover, no patient showed electrocardiograp hic evidence of myocardial infarction. Troponin T was elevated in 17 p atients at 18 to 24 hours after coronary stenting and in eight patient s after PTCA. Both creatine kinase and CKMB were elevated in five pati ents after coronary stenting and in three patients after PTCA. The fre quency of abnormal troponin T levels was significantly higher than tha t of creatine kinase or CKMB after coronary interventions (21% vs 6.7% ; p < 0.01), and it was significantly higher after stenting when compa red with angioplasty alone (29% vs 13%; p < 0.05). Patients with abnor mal troponin T levels were more likely to undergo repeat revasculariza tion than those without (24% vs 6%; p < 0.01). Conclusion Cardiac trop onin T is more sensitive than creatine kinase and CKMB in detecting mi nor myocardial injury after coronary interventions. The incidence of t roponin T release is higher in the patients undergoing stent implantat ion than in patients treated with angioplasty alone.