Portal de Periódicos da CAPES

Prevalence and Effect of Myocardial Injury After Transcatheter Aortic Valve Replacement

2013; Elsevier BV; Volume: 111; Issue: 9 Linguagem: Inglês

10.1016/j.amjcard.2012.12.059

1879-1913

Israel M. Barbash, Danny Dvir, Itsik Ben‐Dor, Salem Badr, Petros Okubagzi, Rebecca Torguson, Paul J. Corso, Zhenyi Xue, Lowell F. Satler, Augusto D. Pichard, Ron Waksman,

Cardiac Imaging and Diagnostics

The incidence and prognostic implication of myocardial injury after transcatheter aortic valve replacement (TAVR) have not been consistently studied. We aimed to assess the incidence and extent of myocardial injury after TAVR performed using transfemoral and transapical approaches. The clinical data from patients with aortic stenosis who underwent TAVR were retrospectively analyzed. The myocardial necrosis markers cardiac troponin I and creatine kinase (CK)-MB were assessed during hospitalization. Of the 150 TAVR patients, 95% and 50% had an abnormally elevated cardiac troponin I and CK-MB level, respectively. The transapical patients had significantly greater elevations of both cardiac troponin I (13.8 ± 14.0 vs 2.5 ± 5.8 ng/ml, p <0.001) and CK-MB (28.4 ± 24.2 vs 7.4 ± 8.6 ng/ml, p ≤0.001). On receiver operating curve analysis, postprocedural CK-MB (twofold increase) had high predictive power for 30-day mortality (area under the curve 0.85, p <0.001). Patients with high CK-MB levels had greater rates of postprocedural kidney injury (22% vs 6%, p = 0.026), in-hospital (22% vs 0%, p <0.001), 30-day (27% vs 1.5%, p 7 ng/ml) in CK-MB after transfemoral TAVR was a surrogate for poor long-term outcomes.