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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Cardiac troponin and adverse outcomes in atrial fibrillation: A meta-analysis

Yichuan Fan1, Xingzhi Zhao1, Xiaodong Li1

  • 1Department of Vascular and Thyroid Surgery, The First Affiliated Hospital, China Medical University, Shenyang 110001, China.

Clinica Chimica Acta; International Journal of Clinical Chemistry
|December 5, 2017
PubMed

Insights

Cardiac troponin elevation in atrial fibrillation (AF) patients independently predicts higher risks of all-cause mortality and major adverse cardiac events (MACEs). Troponin testing aids in risk stratification for AF patients.

Area of Science:

  • Cardiology
  • Biomarkers
  • Clinical Research

Background:

  • The prognostic significance of elevated cardiac troponin in atrial fibrillation (AF) remains uncertain.
  • Cardiac troponins are key biomarkers for myocardial injury.

Purpose of the Study:

  • To conduct a meta-analysis investigating the association between cardiac troponin elevation and adverse outcomes in patients with AF.
  • To clarify the prognostic value of troponin in AF.

Main Methods:

  • Systematic literature search of PubMed and Embase databases up to April 2017.
  • Inclusion of studies measuring cardiac troponin-T (cTnT) or troponin-I (cTnI) in AF patients.
  • Meta-analysis of all-cause mortality and major adverse cardiac events (MACEs) as outcome measures.

Main Results:

  • Six studies comprising 22,697 AF patients were analyzed.
  • Elevated cardiac troponin in AF was independently associated with a 2.04-fold increased risk of all-cause mortality (95% CI 1.56-2.67).
  • Elevated cardiac troponin in AF was independently associated with a 1.93-fold increased risk of MACEs (95% CI 1.61-2.30).

Conclusions:

  • Cardiac troponin elevation in AF patients is an independent predictor of increased all-cause mortality and MACEs.
  • Troponin determination is recommended for risk stratification in AF.
  • The prognostic value of troponin elevation in AF is consistent across various study characteristics.
Abstract

Keywords:
Atrial fibrillationCardiac troponinMajor adverse cardiac eventsMeta-analysisall-cause mortality

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