Predictors and impact of myocardial injury (VARC-3 criteria) after transcatheter aortic valve implantation

Objective. To determine the factors associated with periprocedural increase in high-sensitive troponin I (hsTrI) after transcatheter aortic valve implantation (TAVI), as well as to evaluate prognostic significance of periprocedural myocardial injury (PMI) on survival of patients after TAVI. Material and methods. A retrospective study included 149 patients who underwent TAVI for severe aortic stenosis. Analysis included patients with available assessment of hsTrI before and after TAVI. According to postoperative hsTrI (VARC-3 criteria), all patients were divided into 2 groups: group 1 — patients with 70 times excess of the upper limit of normal (ULN) hsTrI («hsTrI≥70×ULN»), group 2 — patients with hsTrI <70xULN («hsTrI<70×ULN»). Results. PMI occurred in 18.8% of patients. According to multivariate regression analysis, independent predictors of 70-fold increase in hsTrI were age (OR 1.13, 95% CI 1.01—1.26, p=0.03), female sex (OR 15.6, 95% CI 2.57—95.20, p=0.003) and bioprosthesis implantation depth (OR 1.46, 95% CI 1.10—1.94, p=0.009). There were no significant differences in survival rate (85.7% vs. 90.9%, plog-rank=0.48). Conclusion. Age, female gender and bioprosthesis implantation depth were independent predictors of PMI after TAVI. Myocardial injury after TAVI does not affect long-term survival of patients.