Clinical Value Of Troponin â…  And Endothelin Changes Following Coronary Stenting

Objective To explore change and prognostic value of troponin-I following coronary stenting, and to explore endothelin change and its relation to myocardial injury. Methods Troponin-I was monitored before procedure, 12, 24h after procedure in 76 patients who underwent selective coronary stent implantation and with normal troponin-I and CKMB before procedures, in 30 of whom endothelin was monitored before procedure, and immediately, 6h, 24h after procedure. Major cardiovascular events (death, myocardial infarction, revascularization of target vessel and recurrent myocadial ischemia) were recorded in follow-up of 6-12 months. Results Trponin-I increased following procedure in 36.84% of patients who underwent selective coronary stenting and with normal troponin-I and CKMB levels before procedures. In follow-up of 6-12 months, major cardiovascular events occurred without significant difference in group with elevated trponin-I levels as well as with normal trponin-I levels. But there were more events of inhospital recurrent myocadial ischemia in group with elevated trponin-I levels than in group with normal trponin-I levels. In group with elevated trponin-I levels, all recurrent myocadial ischemia occurred in patients with peak trponin-I levels above group average level. Total inflation time and unstable angina were associated with trponin-I elevations following PTCA and /or stent implantation. Endothelin increased immediately after procedure, increased more obviously 6h after procedure, and changed back to the original level 24h after procedure. But there was no significant difference of endothelin levels between group of elevated troponin-I level and group of normal troponin-I level. Conclusion 1 .Ttroponin-I increases following some coronary stent implantations. 2. In hospital recurrent myocadial ischemia increases in patients with elevated troponin-I following coronary stenting. Troponin-I elevation following procedure isn't related to major cardiovascular events in intermediate-term follow-up. 3. Elevation of troponin-I following coronary stent implantation is associated with longer total infaltion time and unstable angina. 4. PTCA and/or stent implantation is followed by endothelin release, which don't seem to relate to injury.