How Meaningful Are Troponin Elevations After PCI?

Registry findings raise questions about the current threshold for MI.

Periprocedural myocardial infarction (MI) is a critical endpoint in percutaneous coronary intervention (PCI) trials. The universal definition of MI is an elevation in either creatine kinase myocardial band (CKMB) or troponin level of 3 times the upper limit of normal. A substantial evidence base supports this threshold for CKMB but is lacking for troponin. To assess the association between CKMB and troponin elevations after PCI and mortality, investigators studied data from an industry-sponsored, multicenter U.S. registry on 4930 consecutive patients (mean age, 65; 69% men) who underwent nonemergent PCI during 2004–2007. Patients with ST-segment-elevation MI, elevated or missing baseline CKMB levels, or missing postprocedural CKMB or tropon…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)