Prognostic Value Of Biochemical Maker Elevation After Elective Coronary Stent Implantation

Objective: To investigate prognostic value and reason of troponin I elevation after elective coronary stenting for the Patients with Unstable Angina Pectoris; to study the correlation among cTnI and MB isoenzyme of creatine kinase (CK-MB) and High sensitive C-reactive protein (Hs-CRP).Methods: cTnI, CK-MB and Hs-CRP were monitored before the procedure and 8h,16h,24h afterwards in 152 patients who, with the disease of Unstable Angina Pectoris, underwent selective coronary stent implantation. The patients were classified as elevation group and normal group depending on the value above of three times of the critical value. Analysis was made on the correlation factors of clinical feature, coronary artery pathological changes and the process of operation and complication. The study end point was the occurrence of Major Cardiovascular Events (death,Q wave myocardial infarction (MI),repeat PCI or coronary artery bypass grafting (CABG)) after elective coronary stenting in hospital and 6-18months of follow-up.Result: we found significant differences in 6-18 months of follow up between the two groups. In hospital recurrent myocardial ischemia occurred more often in group with increased troponin I (P<0.05) than those with normal troponin I. In terms of MACE, there is significant difference between the two groups. After the Logistic regression analysis, we found that total inflation time, lesion type C and branch occlusion after operation correlated with increasing of troponin I(P<0.05). The correlation coefficients between cTnI and CK-MB, between cTnI and Hs-CRP were 0.134 and 0.126 respectively in group with increased cTnI after operation.Conclusion: there was correlation among cTnI, CK-MB and Hs-CRP, but the degree is very feeble. Total inflation time, lesion type C and branch occlusion after operation were associated with the increasing of troponin I; Procedure-related cTnI levels were closely associated with the increases in recurrent myocardial ischemia and overall incidences of MACE. It was an independent predictor of prognosis after CS in-hospital and 6-18months of follow-up.