Predictors and impact of myocardial injury after transcatheter aortic valve replacement: a multicenter registry
J Am Coll Cardiol
; 66(19): 2075-2088, 2015.
Article
in En
| SES-SP, SESSP-IDPCPROD, SES-SP
| ID: biblio-1063629
Responsible library:
BR79.1
Localization: BR79.1
ABSTRACT
BACKGROUND:
Cardiac biomarker release signifying myocardial injury post-transcatheter aortic valve replacement (TAVR) is common, yet its clinical impact within a large TAVR cohort receiving differing types of valve and procedural approaches is unknown.OBJECTIVES:
This study sought to determine the incidence, clinical impact, and factors associated with cardiac biomarker elevation post TAVR.METHODS:
This multicenter study included 1,131 consecutive patients undergoing TAVR with balloon-expandable (58%) or self-expandable (42%) valves. Transfemoral and transapical (TA) approaches were selected in 73.1% and 20.3% of patients, respectively. Creatine kinase-myocardial band (CK-MB) measurements were obtained at baseline and at several time points within the initial 72 h post TAVR. Echocardiography was performed at baseline and at 6- to 12-month follow-up.RESULTS:
Overall, 66% of the TAVR population demonstrated some degree of myocardial injury as determined by a rise in CK-MB levels (peak value 1.6-fold [interquartile range (IQR) 0.9 to 2.8-fold]). A TA approach and major procedural complications were independently associated with higher peak of CK-MB levels (p < 0.01 for all), which translated into impaired systolic left ventricular function at 6 to 12 months post TAVR (p < 0.01). A greater rise in CK-MB levels independently associated with an increased 30-day, late (median of 21 [IQR 8 to 36] months) overall and cardiovascular mortality (p < 0.001 for all)...
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Collection:
06-national
/
BR
Database:
SES-SP
/
SESSP-IDPCPROD
Main subject:
Biomarkers
/
Carotid Stenosis
/
Creatine Kinase
/
Transcatheter Aortic Valve Replacement
Type of study:
Clinical_trials
/
Prognostic_studies
/
Risk_factors_studies
Language:
En
Journal:
J Am Coll Cardiol
Year:
2015
Document type:
Article