Key result
Pre-TAVR high-sensitivity cardiac troponin T >42 ng/L was associated with a higher 3-year incidence of all-cause death and rehospitalization compared to <21 ng/L (HR 1.50; 95% CI 1.32-1.70; p<.001).
Why the study?
Elevations in cardiac troponin T indicate myocardial injury that may influence long-term outcomes after TAVR.
Does elevated pre-interventional high-sensitivity cardiac troponin T predict the composite of all-cause death and any rehospitalization in patients with severe aortic valve stenosis undergoing TAVR?
Observational (n=2,129)
No
Does elevated pre-interventional high-sensitivity cardiac troponin T predict the composite of all-cause death and any rehospitalization in patients with severe aortic valve stenosis undergoing TAVR?
Hazard Ratio: 1.5 (95% CI 1.32–1.7)
Absolute Event Rate: 81.7% vs 70.9%
p-value: p=<.001
Elevated pre-procedural high-sensitivity cardiac troponin T is strongly and independently associated with an increased long-term risk of all-cause death and rehospitalization after TAVR.
BACKGROUND: Constant elevations of the serum concentration of cardiac troponin T (TnT) indicate a myocardial injury that may affect the long-term outcome of transcatheter aortic valve replacement (TAVR). OBJECTIVES: We sought to investigate the impact of pre-TAVR TnT on outcomes after TAVR during long-term follow-up. METHODS: In a retrospective, observational study we compared long term outcomes after TAVR between tertiles of preinterventional high-sensitivity TnT. Systematic follow-up was performed annually for 5 years. The primary endpoint was a composite of all-cause death and any rehospitalization. RESULTS: Between 2010 and 2018, 2,129 patients with severe aortic valve stenosis underwent TAVR at our institution (mean age 82.6 years, 57.2% female, logistic EuroSCORE 20.5 ± 15.8). Boundaries for TnT tertiles were <21 ng/L and >42 ng/L. The median follow-up was 895 days. Three-year incidences for the primary endpoint were 70.9%, 76.6%, and 81.7% in the low, middle, and high tertile (log rank p < .001). Compared with the first tertile, the corresponding adjusted hazard ratios were 1.23 (95%-CI 1.08-1.40, p < .001) and 1.50 (95%-CI 1.32-1.70, p < .001) for the second and third tertile. We found consistent differences between TnT strata for all-cause death (3-year incidences 23.3%, 33.3%, and 47.1%; adjusted p < .001) and rehospitalization (3-year incidences 64.7%, 68.7% and 72.0%; adjusted p < .001), including significant differences in deaths (p < .001). The association between TnT and outcome was independent of coronary artery disease or low aortic valve gradient. CONCLUSIONS: TnT before TAVR is strongly associated with all-cause death and rehospitalization during 3-year follow-up.
No takes yet. Share an insight, caveat, or question.
Schoechlin et al. (2021) conducted an observational in Severe aortic valve stenosis (n=2,129). Preinterventional high-sensitivity cardiac troponin T (TnT) vs. Low tertile of TnT (<21 ng/L) was evaluated on Composite of all-cause death and any rehospitalization (HR 1.50, 95% CI 1.32-1.70, p=<.001). Pre-TAVR high-sensitivity cardiac troponin T >42 ng/L was associated with a higher 3-year incidence of all-cause death and rehospitalization compared to <21 ng/L (HR 1.50; 95% CI 1.32-1.70; p<.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: