The Changes of Cardiac Troponin I and Creatine Kinase MB Isoenzyme after Percutaneous Transluminal Coronary Angioplasty

Background: Percutaneous transluminal coronary angioplasty (PTCA) with or without stenting is a well established technique for coronary revascularization. The injury to the myocardium during the technique was investigated by measuring serum levels for cardiac troponin I and activity of Creatine Kinase MB Isoenzyme (CK-MB), the sensitive and relatively specific biomarkers of cardiac injury. In this study, to detect minor myocardial injury after PTCA, we evaluated serum levels of CTNI and CK-MB after PTCA. Methods: The serum levels of CTNI and the activity of CK-MB were measured by standard methods in 100 patients undergoing elective PTCA, before and 12-24h after the procedure. Patients who had hepatic, renal and thyroid disease ; recent myocardial infarction; electrocardiographic changes, chest pain and myocardial infarction after intervention were excluded from our study. Results: Meaningful differences between the mean levels of CTNI in the samples obtained before and after PTCA; 0.67 ± 0.58 ng/ml VS 1.19 ±0.94 ng/ml (P= 0.000) and those of CK-MB activities; 22.89±8Iu/l VS 26.38±13.39 (P=0.010) were noticed. Stenting place had no effect on the measured parameters. Relationships between history of Hypertension, Diabetes, Hyperlipidemia, Previous myocardial infarction, Smoking and elevations of CTNI and CK-MB levels weren’t statistically significant. The frequency of increased levels of CTNI and CK-MB in women was significantly higher than men. Conclusion: We concluded that minor cardiac injury following PTCA may increase the serum level of CTNI and serum activity of CK-MB. CTNI is more sensitive than CK-MB in detecting of the injury and placing stent has no effect on the release of the parameters during the PTCA. (J Cardiovasc Thorac Res 2009; Vol.1 (1): 11-15)