Troponin Elevation Following Percutaneous Coronary Intervention in Acute Coronary Syndrome

Abstract

Background: Recent advances in revascularization procedures have improved survival rates for individuals with acute coronary syndrome (ACS). However, evidence to guide clinical decision-making for early mobility following percutaneous coronary intervention (PCI) is extremely limited. Purpose: The purpose of this clinical perspective and literature review is to provide context for the clinical interpretation of cardiac troponin (cTn) levels in individuals with ACS following revascularization via PCI and present an evidence-supported clinical decision-making algorithm to guide clinicians in the appropriate timing of initiation of early mobility for individuals with ACS. Methods: A literature review on cTn values is presented to guide the clinical interpretation of laboratory values for clinical decision-making. A comparison of consensus-based guidelines for early mobility is presented as the basis for proposing a novel algorithm for clinical decision-making in individuals with ACS following PCI. Conclusion: The clinical value and utility of postprocedural cTn levels in individuals with ACS following PCI is to help understand prognosis and mortality but does not provide sufficient information about the safety of initiating early mobility following PCI. Decisions for initiation of early mobility in this population using the proposed evidence-supported algorithm may help avoid unnecessary prolongation of bed rest.