Clinical implications of troponin-T elevations following TAVR: Troponin Increase following TAVR
Imamura T, Oshima A, Narang N, et al. Clinical implications of troponin-t elevations following tavr: troponin increase following tavr. J Cardiol. Published online September 15, 2021:S0914-5087(21)00235-5. doi: 10.1016/j.jjcc.2021.08.030.
BACKGROUND: Baseline and post-procedural elevations in serum troponin-T levels are associated with increased morbidity and mortality following transcatheter aortic valve replacement (TAVR). However, the prognostic impact of change in serum troponin-T level following TAVR remains unknown.
METHODS: Among the patients with severe aortic stenosis who underwent TAVR, those with baseline serum troponin-T level ≥51.5 ng/L were excluded. The impact of increases in serum troponin-T level to an abnormally high range (≥51.5 ng/L) following TAVR on 2-year cardiovascular death or heart failure readmissions was investigated.
RESULTS: Among 189 included patients (median 86 years old, 28% men), serum troponin-T level increased in 79 patients following TAVR. An increase in serum troponin-T was associated with a higher rate of 30-day adverse events, predominantly due to pacemaker implantation for complete atrio-ventricular block, and a higher 2-year cumulative incidence of the primary endpoint (hazard ratio 5.24, 95% confidence interval 1.64-16.8, p = 0.005) adjusted for the potential confounders.
CONCLUSION: Post-procedural increase in serum troponin-T level was associated with adverse clinical outcomes following TAVR.