Valve Type May Predict Myocardial Injury After Transfemoral TAVR

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An increase in CK-MB was also not associated with mortality at 30 days.
An increase in CK-MB was also not associated with mortality at 30 days.

HealthDay News — Myocardial injury occurs frequently following transfemoral (TF) transcatheter aortic valve replacement (TAVR), but does not predict outcome, according to a study published in JACC: Cardiovascular Interventions.

Anja Stundl, MD, from Heart Center Bonn in Germany, and colleagues measured cardiac high-sensitivity troponin I (hsTnI) and creatine kinase MB (CK-MB) levels at pre-defined time points in 756 consecutive TF TAVR patients to assess the occurrence of myocardial injury during the first 72 hours.

The researchers found that hsTnI and CK-MB were elevated in 51.6% and 7.4%  of patients, respectively, after uneventful TF TAVR. There was a correlation for myocardial injury with transcatheter heart valve (THV) type: Patients who received LOTUS THV more often had myocardial injury (LOTUS, 81.6%; Direct Flow Medical, 56.4%; CoreValve, 51.2%; Evolut R, 42.7%; SAPIEN XT, 40.4%; SAPIEN 3, 36.6%; P < .001). 

There was no correlation for myocardial injury defined by hsTnI with adverse outcomes at 30 days (3.1 vs 2.7%; P =.778) or 1 year (16.7% vs 17.2%; P = .841). An increase in CK-MB was also not associated with mortality at 30 days (5.5% vs 2.8%; P =.258) or 1 year (16.4% vs 17.3%; P =.856).

"The extent of cardiac biomarker elevation depends on THV type but is not associated with adverse short- and long-term outcomes after uneventful TAVR," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

Reference

Stundl A, Schulte R, Lucht H, et al. Periprocedural myocardial injury depends on transcatheter heart valve type but does nor predict mortality in patients after transcatheter aortic valve replacement. JACC: Cardiovascular Interventions. Aug 2017, 10 (15) 1550-1560.

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