Prognostic value of troponin after elective percutaneous coronary intervention:A meta-analysis

Background: Although the prognostic importance of troponin in patients with an acute coronary syndrome is clear, the significance of troponin elevation after elective percutaneous coronary intervention (PCI) is a subject of debate. However, most studies up to now had a small sample size and insufficient events during follow-up. Methods: Electronic and manual searches were performed of studies reporting on prognosis of troponin after elective PCI. A meta-analysis was done of all suitable studies, with death in follow-up as primary endpoint and the combination of death or non-fatal myocardial infarction in follow-up as secondary endpoint. Results: 20 studies involving 15,581 patients were included. These studies were published between 1998 and 2007. Overall, troponin was elevated after elective PCI in 32.9% of patients. The follow-up period varied between 3 and 67 months (mean 16.3). Increased mortality was significantly associated with troponin elevation after PCI (4.4% vs. 3.3%, P = 0.001; OR 1.35). Furthermore, the combined endpoint of mortality or nonfatal myocardial infarction also occurred more often in patients with post-procedural troponin elevation (8.1% vs. 5.2%, P <0.001; OR 1.59). Conclusions: According to this meta-analysis, troponin elevation after elective PCI proA des important prognostic information. (c) 2008 Wiley-Liss, Inc.