Cardiac enzyme elevations after percutaneous coronary intervention: myonecrosis, the coronary microcirculation and mortality.

One of the most controversial issues in interventional cardiology concerns the meaningfulness of elevated cardiac enzymes after percutaneous coronary interventions. Both single-center observational studies (1–3) and subset analyses from multicenter clinical trials (4,5) have reported an association between postprocedure creatine kinasemyocardial band (CK-MB) elevations and adverse shortand long-term clinical outcomes, including mortality. Other investigators have failed to demonstrate this relationship, maintaining that while cardiac enzymes are frequently elevated after percutaneous coronary procedures, the prognostic implications of this finding are unclear (6).