In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Evaluation of pre and post-procedure high sensitive cardiac troponin T values in patients undergoing elective coronary angiography

Session Poster session 1

Speaker Zeki Ongen

Event : ESC Congress 2017

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease (Chronic)
  • Session type : Poster Session

Authors : Z Ongen (Istanbul,TR), E Erturk (Istanbul,TR), B Kilickiran Avci (Istanbul,TR), M Kucur (Istanbul,TR), B Karadag (Istanbul,TR)

Authors:
Z. Ongen1 , E. Erturk1 , B. Kilickiran Avci1 , M. Kucur2 , B. Karadag1 , 1Istanbul University (1453), Cardiology - Istanbul - Turkey , 2Istanbul University, Pediatrics - Istanbul - Turkey ,

Citation:
European Heart Journal ( 2017 ) 38 ( Supplement ), 203-204

Background: High troponin (cTn) levels indicate a poor prognosis of cardiac diseases even in non-acute setting.

Purpose: By measuring pre and post procedural high sensitive (hs) cTnT we aimed to investigate whether diagnostic angiography cause any myocardial injury and also to search the relationship between pre and post angiographic hs cTnT levels and clinical adverse events in patients (pts) with stable coronary artery disease (SCAD) who underwent diagnostic angiography.

Methods: This prospective single blinded study included 253 pts with SCAD in whom myocardial ischemia was shown by noninvasive tests, except in 6%. None of the pts had any disorder that may elevate pre-procedural cTn levels. Coronary angiographies were mainly performed via femoral route. Pre and post-angiographic 4th hour venous blood samples were driven for hs cTnT measurement. A hs cTnT level >14 ng/L (over 99th pecentile) was accepted as elevated. For all pts demographic, clinical and laboratory findings, risk factors and medications were recorded to a data base. Death, acute coronary syndromes, re-vascularization and hospitalization were specified as clinical adverse events and all pts were followed at least for 3 months. For statistical analysis Khi square, Fisher, Mann-Whitney and Kruskal-Wallis tests were used, accordingly.

Results: Advanced age (r=0.157; p=0.012), lower EF (r=-0.212, p=0.002) and higher blood urea levels (r=0.190, p=0.002) were related with pre and post angiographic higher hs cTnT levels. Compared to baseline there was a mean 0.14 ng/L increase in post angiographic cTnT levels. The amount of dye was the only significant parameter related with the post-angiographic elevation of hs cTnT (r=0.127, p=0.044). Although there was a trend of elevation in hs cTnT levels in pts with higher diastolic blood pressure, it did not reach to a significant level (p=0.068). The pts were followed for mean 223±149 days. Clinical adverse events were significantly higher in pts whose pre and post angiographic hs cTnT levels were elevated (p<0.001 for both pre and post procedural levels). By 17.4% coronary re-vascularization was the most common clinical event, followed by hospitalization for cardiac reasons (7,1%) and acute coronary syndromes (1.2%). There was no deaths.

Conclusion: Since the amount of the dye found to be related with the rise of hs cTnT, in order to prevent myocardial injury during diagnostic angiography unnecessary shots should be avoided. Otherwise the procedure is safe in terms of myocardial injury. As shown in other studies in a non-acute clinical setting the high cTn levels predict adverse clinical events.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Members get more

Join now
  • 1ESC Professional Members – access all resources from general ESC events 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are