Troponin T 0.01 n: Well, why did you go to the ER, did you had chest pain? were you aware of coronary disease you may had? have you had a PCI in the past, or at this time in the ER? TpT< 0.01 outs you in a safe bracket. Preprocedural cTnT is a powerful independent predictor of prognosis after nonemergency PCI. Our data suggest that the observed association between post-PCI myonecrosis and outcomes in prior studies is a reflection of the preprocedural risk that may be estimated by using baseline cTnT and clinical characteristics. Moreover, the findings highlight the critical importance of early initiation of therapies proven to improve outcomes, such as glycoprotein IIb/IIIa inhibitors and aggressive secondary prevention measures, in any patient with an elevated preprocedural cTnT.29 PCI in patients with normal preprocedural cTnT (<0.01 ng/mL) is extremely safe. In these patients, an elevation in troponin after PCI is common and predicts short-term but not long-term risk of death. Extending hospitalization solely on the merits of a minor elevation in cTnT, in the absence of a significant procedural complication or clinical indications, is unlikely to be beneficial. Finally, it is unlikely that additional clinically relevant information can be gained from the post-PCI cTnT levels in patients with elevated preprocedural values, independent of baseline clinical risk and any procedural complications that may occur.
Answered 2/19/2020
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