冠状动脉介入术后6小时内肌钙蛋白T和术后早期临床事件的关系

Relationship between early clinical events and value of cardiac troponin T within 6 hours after percutaneous coronary intervention

目的 分析介入术后 6小时内肌钙蛋白T(cTnT)与术后早期临床事件的关系。方法 术前和术后 6h内测定 115例行冠状动脉介入治疗患者的cTnT值 ,分析术后 6h内不同cTnT值与早期不良临床事件 (心绞痛复发、症状性低血压和二次介入治疗 )发生的关系。结果 术后 6h内cTnT>0 1ng ml检出率高于CK MB(2 0 9%vs 9 6 % ,P =0 0 17) ,患者术后早期心绞痛复发率增高 ;当cTnT为 0 0 1～ 0 1ng ml时 ,患者术后早期症状性低血压的发生率明显增高。Logistic回归分析表明 ,术后 6h内cTnT >0 0 1ng ml增加了早期不良临床事件发生危险性 (OR =7 8,P =0 0 0 0 2 )。结论 冠状动脉介入术后cTnT增高 (>0 1ng ml)及微量cTnT(0 0 1～ 0 1ng ml)与术后早期不良临床事件发生的危险性增高可能密切相关。

Objective To evaluate the relationship between value of cardiac troponin T (cTnT) within 6 hours after percutaneous coronary intervention and the incidence of acute clinical events after intervention Methods 115 patients underwent percutaneous coronary angioplasty (PTCA) with or without stenting Value of cTnT before and 6 hours after intervention was measured The early adverse clinical events (death,recurrent angina, symptomatic hypotension and re PTCA) were investigated at different levels of cTnT within 6 hours after intervention Results The incidence of cTnT>0 1 ng/ml was higher than that of CK MB within 6 hours following successful PTCA or stenting (20 9% vs 9 6%, P =0 017) The higher incidence of early recurrent angina was seen in the patients with cTnT>0 1 ng/ml within 6 hours after coronary intervention Early symptomatic hypotension occurred in these patients with cTnT value from 0 001 to 0 1 ng/ml Therefore,according to logistic regression analysis, cTnT>0 01 ng/ml within 6 hours after intracoronary intervention was associated with higher risk of early major adverse clinical events in hospitalization (OR=7 8, P =0 000?2) Conclusion Elevation (>0 1 ng/ml) and minor value (0 01～0 1 ng/ml) in cardiac troponin T within 6 hours after PCA may be correlated with an increased risk for early adverse clinical outcomes after successful operation