High-sensitivity troponin T is a prognostic marker for patients with aortic stenosis after valve replacement surgery
Toshinobu Saito1, Yukihiro Hojo, Masahiro Hirose
1Department of Cardiology, Jichi Medical University, 3311 Yakushiji, Shimotsuke-city, Tochigi 329-0498, Japan.
Insights
High-sensitivity troponin T (hs-TnT) can predict major adverse cardiac events in aortic stenosis (AS) patients undergoing valve replacement. Elevated hs-TnT levels indicate a higher risk of mortality and heart failure post-surgery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Biomarker Research
Background:
- Aortic stenosis (AS) is a significant cause of sudden cardiac death.
- High-sensitivity troponin T (hs-TnT) is a validated mortality marker for cardiovascular diseases.
- The prognostic utility of hs-TnT in AS patients undergoing surgery requires further investigation.
Purpose of the Study:
- To determine if hs-TnT can serve as a prognostic marker for operative outcomes in patients with aortic stenosis.
- To evaluate the association between hs-TnT levels and major adverse cardiac events (MACE) following aortic valve replacement.
Main Methods:
- Sixty AS patients (mean age 68.7 years) underwent cardiac catheterization, echocardiography, and aortic valve replacement.
- Major adverse cardiac events (MACE) were defined as heart failure, fatal arrhythmia, or all-cause death.
- Patients were stratified into three groups based on hs-TnT plasma levels for survival analysis.
Main Results:
- Over a follow-up of 922 ± 800 days, 18% of patients experienced MACE, including 5 sudden cardiac deaths.
- Kaplan-Meier analysis showed a significant difference in MACE rates across hs-TnT groups (p=0.002).
- Cox proportional hazard analysis identified hs-TnT tertile as a significant predictor of MACE (HR: 3.71, p=0.03), independent of other clinical factors.
Conclusions:
- High-sensitivity troponin T (hs-TnT) is a valuable prognostic marker for patients with aortic stenosis.
- hs-TnT levels can predict adverse outcomes, including mortality, in AS patients after valve replacement surgery.
Background:
Aortic stenosis (AS) is recognized as a cause of sudden cardiac death. Recently, the measurement of high-sensitivity troponin T (hs-TnT) has become possible. Several studies have clarified that hs-TnT is a marker to indicate mortality of cardiovascular diseases.
Objectives:
To examine whether hs-TnT can be used as a prognostic marker to predict the operative outcome of AS.
Methods:
We enrolled 60 patients with AS (mean age=68.7 ± 9.6 years, male/female=30/30). Cardiac catheterization and echocardiography were performed to evaluate the severity of AS. Aortic valve replacement surgery was performed in all patients. We defined major adverse cardiac events (MACE) as composite events of heart failure, fatal arrhythmia, and all causes of death.
Results:
We followed up the patients for 922 ± 800 days. Mean left ventricular ejection fraction was 60.0 ± 1.8%. Mean aortic valve area was 0.61 ± 0.03 cm(2). MACE occurred in 11 patients (18%), including 5 sudden cardiac deaths. We divided the patients into three groups based on the percentile of the plasma levels of hs-TnT. Kaplan-Meier curve revealed a statistically significant difference in MACE rate among the groups (log-rank test, χ(2)=13.0, p=0.002). We conducted a Cox proportional hazard analysis with a model including age, sex, estimated glomerular filtration rate, and hs-TnT tertile as explanatory variables to predict MACE. We found that hs-TnT tertile to be a significant factor to predict MACE (hazard ratio: 3.71, p=0.03).
Conclusions:
hs-TnT can be a prognostic marker for patients with AS after valve replacement surgery.
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