Predictors and Prognostic Implications of Myocardial Injury After Transcatheter Aortic Valve Replacement

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Guney M. C., KELEŞ T., Karaduman B. D., Ayhan H., Suygun H., Kahyaoglu M., ...Daha Fazla

Texas Heart Institute Journal, cilt.49, sa.4, 2022 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 49 Sayı: 4
  • Basım Tarihi: 2022
  • Doi Numarası: 10.14503/thij-20-7380
  • Dergi Adı: Texas Heart Institute Journal
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, EMBASE, MEDLINE
  • Anahtar Kelimeler: Aortic stenosis/diagnosis, decision support techniques, heart injuries/etiology, patient selection, postoperative complications, retrospective studies, risk assessment/methods, severity of illness index, transcatheter aortic valve replacement/adverse effects, treatment outcome
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Ankara Yıldırım Beyazıt Üniversitesi Adresli: Evet

Özet

© 2022 by the Texas Heart® Institute, Houston.Myocardial injury (MI) is not unusual after transcatheter aortic valve replacement (TAVR). To determine precipitating factors and prognostic outcomes of MI after TAVR, we retrospec-tively investigated relationships between MI after TAVR and aortic root dimensions, baseline patient characteristics, echocardiographic findings, and procedural features. Of 474 patients who underwent transfemoral TAVR for severe aortic stenosis in our ter-tiary center from June 2011 through June 2018, 188 (mean age, 77.7 ± 7.7 yr; 96 women [51%]) met the study inclusion criteria. Patients were divided into postprocedural MI (PMI) (n=74) and no-PMI (n=114) groups, in accordance with high-sensitivity troponin T levels. We found that MI risk was associated with older age (odds ratio [OR]=1.054; 95% CI, 1.013–1.098; P=0.01), transcatheter heart valve type (OR=10.207; 95% CI, 2.861–36.463; P=0.001), distances from the aortic annulus to the right coronary artery ostium (OR=0.853; 95% CI, 0.731–0.995; P=0.04) and the left main coronary artery ostium (OR=0.747; 95% CI, 0.616–0.906; P=0.003), and baseline glomerular filtration rate (OR=0.985; 95% CI, 0.970–1.000; P=0.04). Moreover, the PMI group had a longer time to hospital discharge (P=0.001) and a higher permanent pacemaker implantation rate (P=0.04) than did the no-PMI group. Our findings may enable better estimation of which patients are at higher risk of MI after TAVR and thus improve the planning and course of clinical care.