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Objectives: To evaluate myocardial injury and infarction (MI) following elective percutaneous coronary intervention (PCI)., Background: The substantially higher analytical power of high-sensitivity troponin (hsTn) assays allows detection of minor cardiac troponin (cTn) levels, which may be useful in monitoring myocardial injury and guiding therapies., Methods: Serial hsTnT measurements were conducted in patients undergoing elective PCI and were related to the extent of coronary artery disease (CAD) as reflected by the SYNTAX score risk categories and American College of Cardiology/American Heart Association classification of coronary lesions. Myocardial injury and MI were diagnosed according to the second and third versions of universal MI definition., Results: The study population consisted of 530 patients, who were grouped into low (41.3%), intermediate (35.4%), and high (23.3%) SYNTAX risk categories. The treated coronary lesions were classified into A 7.8%, B1 24.1%, B2 21.1%, C1 24.6%, and C2 22.4%. Postprocedural hsTnT increases correlated significantly with the complexity of treated coronary lesions (p < .05) and CAD magnitude (p < .05). Rates of MI type 4a according to the second and third MI definition criteria were 98 (27.5%) and 15 (4.2%) cases in patients with normal baseline hsTnT values (N = 357, 67.4%), as well as 137 (79.2%) and 27 (15.6%) cases in those with elevated baseline hsTnT values (N = 173, 32.6%), respectively., Conclusions: After elective PCI, cTn releases correlate significantly with lesion complexity and CAD extent. Use of hsTnT assay enables precise monitoring of PCI-related myocardial injury and may identify patients at higher risk for ischemic events, who may benefit from potent platelet inhibition, which needs to be investigated in randomized trials., (© 2019 Wiley Periodicals, Inc.)

Aims: To investigate the prognostic implications of elevated high-sensitivity cardiac troponin T (hs-cTnT) values in presumably stable ambulatory coronary artery disease patients., Methods and Results: We conducted a retrospective, single-centre pilot observational study in a low-risk population. All patients received routine measurement of hs-cTnT at index and follow-up visits. Endpoints were all-cause mortality and a composite of all-cause mortality, acute myocardial infarction, stroke and rehospitalization for acute coronary syndrome and heart failure. Nine hundred and sixty-five consecutive patients presenting to our outpatient clinic between June 2009 and June 2010 were screened; 693 patients with a stable clinical course, at least one hs-cTnT value and at least one follow-up visit qualified for analysis. Follow-up was 796 days. Five hundred and forty-seven patients (78.9%) had hs-cTnT values below and 146 patients (21.1%) had values above 14 ng/l, which was defined to categorize high and low levels as it was reported to be the 99th percentile of a reference population. We observed 13 deaths (all-cause mortality) including four cardiovascular deaths. Age, N terminal pro-brain natriuretic peptide levels and impaired renal function were independently associated with an elevated hs-cTnT in a multivariate analysis. Hs-cTnT values >14 ng/l were strongly associated with all-cause mortality (hazard ratio 12.9, 95% confidence interval (CI): 3.5-46.9, p=0.0001), the composite clinical endpoint (hazard ratio 2.35, 95% CI: 1.48-3.72, p=0.0003) and rehospitalization for heart failure (hazard ratio 3.36, 95% CI: 1.73-6.53, p=0.0004). Compared with the multivariable Framingham score hs-cTnT revealed a significantly better performance (area under the receiver operating characteristics curve (AUC) hs-cTnT: 0.882 vs. AUC Framingham score 0.639, p=0.0005)., Conclusion: Elevated hs-cTnT levels provide excellent prognostic information regarding all-cause mortality and a combined clinical endpoint in presumably stable ambulatory coronary artery disease outpatients presenting for routine evaluation., (© The European Society of Cardiology 2015.)

Background: Elevated cardiac troponin (cTn) has been reported to occur with AVNRT. Little is known about prevalence, kinetic changes, and possible reasons of increased cTn. Methods: We evaluated 139 consecutive patients presenting with AVNRT to the emergency department between 2006 and 2010. Cardiac troponin T (cTnT) was measured serially at baseline, after three and six hours. Patients were evaluated for the presence of structural heart disease or CAD. Troponin was defined as elevated if a value exceeded the lower limit of detection (10 ng/l) using the fourth generation cTnT, or if the value > 99th percentile (14 ng/l) using the new highly sensitive cTn assay. Results: A cTnT > LLD ( n = 29) or > 99th percentile ( n = 16) was found in 45 patients (32.4%) within the initial six hours after hospitalization. All patients were symptomatic with palpitations, chest discomfort or dyspnea. A complete cardiac evaluation was carried out, including coronary angiography in 32 patients demonstrating an underlying structural heart disease or CAD in 18 cases (56%). Significant CAD was detected in 16 cases. 8 cases required PCI during hospitalization. Elevated cTnT was seen in patients with and without structural heart disease. Conclusions: AVNRT is a possible reason for elevated cTnT, even in the absence of relevant structural heart disease or CAD. [ABSTRACT FROM AUTHOR]