Key result
Transcatheter septal defect closure is linked to minimal cTnI rise in ~41% unrelated to short-term outcomes.
Why the study?
Does transcatheter closure of the interatrial septum cause significant cTnI release and affect short-term prognosis in patients with ASD or PFO?
Cohort (n=78)
Does transcatheter closure of the interatrial septum cause significant cTnI release and affect short-term prognosis in patients with ASD or PFO?
Transcatheter closure of interatrial septal defects is associated with a minimal, prognostically benign rise in cTnI in about 40% of patients, which correlates with device size and procedural technique.
Minimal cTnI rise after transcatheter ASD/PFO closure appears benign short-term; leaves open need for prospective validation and long-term data.
OBJECTIVE: To identify cTnI rise after percutaneous ISD closure and to determine its prognostic significance. BACKGROUND: Cardiac troponin-I (cTnI) is a very specific and sensitive marker of myocardial injury. A significant increase of cTnI levels after percutaneous interatrial septal defect (ISD) closure has been reported. METHODS: Patients admitted for transcatheter atrial septal defect (ASD) and patent foramen ovale (PFO) closure, were enrolled in this prospective study. Standard protocol was unchanged, except for blood sampling, to which serial cTnI before, 6, and 24 hours after the procedure was added. RESULTS: Seventy-eight patients (female/male 37/41, mean age 55 +/- 13 y, 14 ASD and 64 PFO) were included. In none of the patients cTnI was elevated before the procedure and in no patients a cTnI rise above the WHO-criteria for myocardial infarction (> = 0.4 ng/ml) was seen. However, in 32 patients (41%) minimal cTnI rise (range from 0.04 ng/ml to 0.37 ng/ml) was present within a time frame of 24 hours. The increase in cTnI was not related to peri-procedural complications and to short-term outcome (mean follow-up time of 7 +/- 5 months). In addition, cTnI rise was significantly related with the presence of hyperlipideamia (P = 0.004), device size (P = 0.008), and the absence of balloon sizing (P = 0.017). CONCLUSIONS: Transcatheter closure of ISD seems to be a safe procedure. A minimal but significant increase of cTnI is noted in some patients after the procedure, but it seems not to be related to short-term prognosis. However, cTnI rise is clearly associated with patients' characteristics and peri-procedural variables.
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Vydt et al. (2007) conducted a cohort in Atrial septal defect (ASD) and patent foramen ovale (PFO) (n=78). Transcatheter closure of interatrial septal defect was evaluated on Minimal cardiac troponin I (cTnI) rise within 24 hours. Transcatheter closure of interatrial septal defects was associated with a minimal cardiac troponin I rise in 41% of patients within 24 hours, which did not relate to short-term clinical outcomes.
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