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What Causes High Troponin Levels After Coronary Stenting?
Question: how long after a heart XXXXXXX that placed 3 stents in my heart, should my triponin levels be back to normal
Brief Answer:
Several factors influence abnormally high troponin concentration window.
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
Regarding your concern, I would like to explain that high troponin levels are a marker of serious myocardial injury (severe myocardial ischemia and myocardial infarction).
Generally, after a revascularisation procedure, the chances that troponin levels continue to increase or remain high decrease, as coronary angioplasty and stents implantation restore normal coronary blood flow and interrupt myocardial ischemia and necrosis process (unless something gets wrong, like thrombotic stent complication, etc).
If you have experienced a myocardial infarction prior to stents implantation, depending on the severity of myocardial mass involved, troponin level will show an abnormally high blood level ranging from 7 to 14 days (though tending lower trend).
Nevertheless, troponin levels will depend also from assay type applied; high sensitive troponin will show a more prolonged turn over (abnormal high concentration window) than standard troponin assay.
In addition, other co-morbidities like renal dysfunction, pulmonary infection, heart failure, etc may influence the prolonged increased blood levels, as well.
Hope to have been helpful!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
Several factors influence abnormally high troponin concentration window.
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
Regarding your concern, I would like to explain that high troponin levels are a marker of serious myocardial injury (severe myocardial ischemia and myocardial infarction).
Generally, after a revascularisation procedure, the chances that troponin levels continue to increase or remain high decrease, as coronary angioplasty and stents implantation restore normal coronary blood flow and interrupt myocardial ischemia and necrosis process (unless something gets wrong, like thrombotic stent complication, etc).
If you have experienced a myocardial infarction prior to stents implantation, depending on the severity of myocardial mass involved, troponin level will show an abnormally high blood level ranging from 7 to 14 days (though tending lower trend).
Nevertheless, troponin levels will depend also from assay type applied; high sensitive troponin will show a more prolonged turn over (abnormal high concentration window) than standard troponin assay.
In addition, other co-morbidities like renal dysfunction, pulmonary infection, heart failure, etc may influence the prolonged increased blood levels, as well.
Hope to have been helpful!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Reason I asked is, 2 days after being released from the hospital, I am having chest pains on and off, I think something was missed or one of the stents isnt performing as it should and have gone to the hospital and they treat me as if nothings wrong. I am scared to lose more of my heart and can not get these people to they see the triponin yet attribute it to the past event, and dont seem to be listening to me as to how i feel and want them to go back in and fix whats not working.
Brief Answer:
You should discuss with your cardiologist for a new troponin & CK-MB test.
Detailed Answer:
Hi again, dear XXXX!
I understand your concern; I would say you are right. If high clinical suspicions (clinical symptomatology) for an ongoing myocardial ischemia (due to a stent complication like stent thrombosis, which is more possible to happen during the early period after revascularization procedure [during 24 hours to several weeks]) are raised, then a newly increased troponin level is a strong and unequivocal indicator for rechecking the coronary arteries status and promptly intervening if necessary.
So, though troponin has a relatively prolonged plasmatic window (abnormally increased blood levels) when a myocardial infarction occurs, a suspicious chest pain, coupled with new increase of troponin and CK-MB levels is an expression of an ongoing myocardial cells damage and an angiographic review of stents patency should be done.
You should discuss with your attending cardiologist and insist for a new laboratory check of troponin & CK-MB levels without delay.
Best regards,
Dr. Iliri
You should discuss with your cardiologist for a new troponin & CK-MB test.
Detailed Answer:
Hi again, dear XXXX!
I understand your concern; I would say you are right. If high clinical suspicions (clinical symptomatology) for an ongoing myocardial ischemia (due to a stent complication like stent thrombosis, which is more possible to happen during the early period after revascularization procedure [during 24 hours to several weeks]) are raised, then a newly increased troponin level is a strong and unequivocal indicator for rechecking the coronary arteries status and promptly intervening if necessary.
So, though troponin has a relatively prolonged plasmatic window (abnormally increased blood levels) when a myocardial infarction occurs, a suspicious chest pain, coupled with new increase of troponin and CK-MB levels is an expression of an ongoing myocardial cells damage and an angiographic review of stents patency should be done.
You should discuss with your attending cardiologist and insist for a new laboratory check of troponin & CK-MB levels without delay.
Best regards,
Dr. Iliri
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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