Troponin T Elevation After Percutaneous Left Atrial Appendage Occlusion

Area of Science:

• Cardiology
• Biomarkers
• Medical Devices

Background:

• Cardiac troponin T (cTNT) is a key indicator of cardiac damage, with elevated levels correlating to increased mortality in various heart conditions.
• Elevated cTNT is frequently observed post-left atrial appendage occlusion (LAAO).

Purpose of the Study:

• To investigate the incidence, clinical significance, and contributing factors of cTNT elevation following LAAO procedures.
• To assess the relationship between post-LAAO cTNT levels and major adverse cardiovascular events or periprocedural complications.

Main Methods:

• Prospective study of 190 patients undergoing LAAO from January 2019 to July 2020.
• Patients categorized based on post-procedure cTNT levels (elevated vs. normal).
• One-year follow-up for major adverse cardiovascular events (MACE) and periprocedural complications.

Main Results:

• A high incidence of cTNT elevation (85.3%) was observed after LAAO.
• Factors such as procedure duration, contrast dosage, LAAO device type, and LAA morphology influenced cTNT levels.
• Watchman device use was associated with higher cTNT elevation compared to Lambre device (89.2% vs. 76.7%, p=0.029).
• No significant difference in MACE or complications between groups with and without cTNT elevation (p-values > 0.05).

Conclusions:

• LAAO frequently results in cTNT elevation, which appears unrelated to 1-year adverse cardiac outcomes or complications.
• Baseline eGFR, procedural factors (exposure time, contrast dose), LAAO device type, and LAA anatomy are potential contributors to post-LAAO cTNT elevation.