Prognostic Impact of Pre-Transcatheter and Post-Transcatheter Aortic Valve Intervention Troponin: A Large Cohort Study.

Background Biomarkers were advocated as prognostic factors in patients undergoing transcatheter aortic valve intervention, with contradictory results concerning prognostic impact of troponin. Our aim was to assess the prognostic impact of preprocedural and postprocedural troponin in transcatheter aortic valve intervention. Methods and Results Preprocedural and postprocedural high-sensitivity troponin levels were measured in all patients undergoing transcatheter aortic valve intervention. Primary end point was 1-year mortality. This study included 1390 patients, with a mean age of 83.4±6.8 years. Patients were divided into 3 tertiles according to preprocedural troponin values: tertile 1: 0.001 to 0.023 μg/L; tertile 2: 0.024 to 1.80 μg/L; and T3: 1.81 to 12.1 μg/L. One-year mortality was higher in patients in tertile 2 (hazard ratio, 2.1; P=0.001) and T3 (hazard ratio, 1.8; P=0.009) compared with those in tertile 1. Myocardial injury was predictive of 1-year mortality (hazard ratio, 1.7; P=0.01). This effect may be stronger in the tertile 1 subgroup (hazard ratio, 5.1; P=0.03 [ P value for interaction: 0.18]). Conclusions Elevated preprocedural troponin and myocardial injury are associated with 1-year mortality after transcatheter aortic valve intervention.