OBJECTIVES: This study sought to: 1) determine the incidence, degree, and timing of the rise in serum cardiac markers of myocardial injury associated with uncomplicated transcatheter aortic valve implantation (TAVI); and 2) evaluate the predictive factors and prognostic value of myocardial injury associated with TAVI. BACKGROUND: Very few data exist on the occurrence and clinical relevance of myocardial injury during TAVI procedures. METHODS: A total of 101 patients who underwent successful TAVI (transfemoral [TF] approach, n = 38; transapical [TA] approach, n = 63) were included. Creatine kinase-MB (CK-MB) and cardiac troponin T (cTnT) levels were determined at baseline and at 6 to 12, 24, 48, and 72 h following TAVI. RESULTS: TAVI was associated with some degree of myocardial injury in 99% of the patients (TF: 97%, TA: 100%) as determined by a rise in cTnT (maximal value, 0.48 μg/l, interquartile range [IQR]: 0.24 to 0.82 μg/l) and in 77% of the patients (TF: 47%, TA: 95%) as determined by a rise in CK-MB (maximal value, 18.6 μg/l; IQR: 11.0 to 27.4 μg/l). TA approach and baseline renal dysfunction were associated with a higher increase in biomarkers of myocardial injury (p < 0.01 for both). A larger myocardial injury was associated with a smaller improvement of left ventricular ejection fraction (LVEF) (p < 0.01). The degree of rise in cTnT was an independent predictor of cardiac mortality at 9 ± 10 months of follow-up (hazard ratio: 1.14 per each increase of 0.1 μg/l, 95% confidence interval: 1.02 to 1.28, p = 0.028). CONCLUSIONS: TAVI was systematically associated with some degree of myocardial injury, with TA approach and baseline renal dysfunction determining a higher increase in biomarkers of myocardial injury. A greater degree of myocardial injury was associated with less improvement in LVEF and a higher cardiac mortality at follow-up.
OBJECTIVES: This study sought to: 1) determine the incidence, degree, and timing of the rise in serum cardiac markers of myocardial injury associated with uncomplicated transcatheter aortic valve implantation (TAVI); and 2) evaluate the predictive factors and prognostic value of myocardial injury associated with TAVI. BACKGROUND: Very few data exist on the occurrence and clinical relevance of myocardial injury during TAVI procedures. METHODS: A total of 101 patients who underwent successful TAVI (transfemoral [TF] approach, n = 38; transapical [TA] approach, n = 63) were included. Creatine kinase-MB (CK-MB) and cardiac troponin T (cTnT) levels were determined at baseline and at 6 to 12, 24, 48, and 72 h following TAVI. RESULTS: TAVI was associated with some degree of myocardial injury in 99% of the patients (TF: 97%, TA: 100%) as determined by a rise in cTnT (maximal value, 0.48 μg/l, interquartile range [IQR]: 0.24 to 0.82 μg/l) and in 77% of the patients (TF: 47%, TA: 95%) as determined by a rise in CK-MB (maximal value, 18.6 μg/l; IQR: 11.0 to 27.4 μg/l). TA approach and baseline renal dysfunction were associated with a higher increase in biomarkers of myocardial injury (p < 0.01 for both). A larger myocardial injury was associated with a smaller improvement of left ventricular ejection fraction (LVEF) (p < 0.01). The degree of rise in cTnT was an independent predictor of cardiac mortality at 9 ± 10 months of follow-up (hazard ratio: 1.14 per each increase of 0.1 μg/l, 95% confidence interval: 1.02 to 1.28, p = 0.028). CONCLUSIONS: TAVI was systematically associated with some degree of myocardial injury, with TA approach and baseline renal dysfunction determining a higher increase in biomarkers of myocardial injury. A greater degree of myocardial injury was associated with less improvement in LVEF and a higher cardiac mortality at follow-up.
Authors: Jochen Reinöhl; Constantin von Zur Mühlen; Martin Moser; Stefan Sorg; Christoph Bode; Manfred Zehender Journal: J Thromb Thrombolysis Date: 2013-05 Impact factor: 2.300
Authors: Emmanuel Chorianopoulos; Ulrike Krumsdorf; Nicolas Geis; Sven T Pleger; Evangelos Giannitsis; Hugo A Katus; Raffi Bekeredjian Journal: Clin Res Cardiol Date: 2013-10-06 Impact factor: 5.460
Authors: Jean-Michel Paradis; Hersh S Maniar; John M Lasala; Susheel Kodali; Mathew Williams; Brian R Lindman; Ralph J Damiano; Marc R Moon; Raj R Makkar; Vinod H Thourani; Vasilis Babaliaros; Ke Xu; Girma Minalu Ayele; Lars Svensson; Martin B Leon; Alan Zajarias Journal: JACC Cardiovasc Interv Date: 2015-09 Impact factor: 11.195
Authors: Won-Keun Kim; Christoph Liebetrau; Arnaud van Linden; Johannes Blumenstein; Luise Gaede; Christian W Hamm; Thomas Walther; Helge Möllmann Journal: Clin Res Cardiol Date: 2015-12-15 Impact factor: 5.460