TY - JOUR JO - EuroIntervention TI - Periprocedural elevated myocardial biomarkers and clinical outcomes following elective percutaneous coronary intervention: a comprehensive dose-response meta-analysis of 44,972 patients from 24 prospective studies AB - <p><strong>Aims:</strong> The optimal cut-off value of isolated cardiac biomarker elevation for defining prognostically important percutaneous coronary intervention (PCI)-related myocardial injury is not known. We performed a meta-analysis to evaluate the dose-response relationship between isolated cardiac biomarker elevations and the risk of all-cause mortality following elective PCI.</p> <p><strong>Methods and results:</strong> Twenty-four prospective studies (44,972 patients) were included. Patients with an isolated elevation of cardiac biomarkers had an increased risk of all-cause mortality when compared to those with no elevations (cardiac troponin I: odds ratio [OR] 1.42, 95% confidence interval [CI]: 1.19-1.69; creatine kinase-MB isoenzyme [CK-MB]: OR 1.43, 95% CI: 1.19-1.70). For the dose-response analysis, elevations of cardiac troponin I &gt;3x or CK-MB &gt;1x the 99<sup>th</sup> percentile upper reference limit (URL) were associated with increased mortality (cardiac troponin I: OR 1.51, 95% CI: 1.05-2.17; CK-MB: OR 1.25, 95% CI: 1.05-1.48). The pooled OR of mortality for each 3xURL increment of cardiac troponin I or CK-MB was 1.33 (95% CI: 1.15-1.53) and 1.38 (95% CI: 1.30-1.47).</p> <p><strong>Conclusions:</strong> We found that a positive dose-response relationship between isolated cardiac troponin I and CK-MB with all-cause mortality and elevated cardiac troponin I &gt;3x or CK-MB &gt;1x the 99<sup>th</sup> percentile URL was associated with an increased risk of mortality.</p> AU - Li Yuehua AU - Pei Hanjun AU - Bulluck Heerajnarain AU - Zhou Chenghui AU - Hausenloy J Derek VL - 15 IS - 16 Y1 - 20/03/2020 Y1 - 2020 DOI - 10.4244/EIJ-D-19-00737 SP - 1444 EP - 1450 KW - myocardial infarction KW - death KW - stable angina PB - Europa Digital & Publishing SE - Coronary interventions UR - https://eurointervention.pcronline.com/article/peri-procedural-elevated-myocardial-biomarkers-predict-adverse-clinical-outcomes-following-elective-percutaneous-coronary-intervention-a-comprehensive-dose-response-meta-analysis-of-24-prospective-studies-with-44972-patients SN - 1774-024X ER -