Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
J Cardiovasc Electrophysiol. 2019 Sep;30(9):1475-1482. doi: 10.1111/jce.14032. Epub 2019 Jul 2.
This study aimed to evaluate the utility of high-sensitive troponin T (hs-TnT) for predicting AF recurrence and major adverse cardiovascular events (MACE) after AF ablation.
A total of 227 consecutive patients with AF (mean age, 66 ± 10 years; persistent AF, n = 98) who underwent an initial ablation were enrolled. We measured hs-TnT before AF ablation and divided the patients into three groups according to the hs-TnT level: low, lesser than or equal to 0.005 µg/L (n = 54); medium, 0.006-0.013 µg/L (n = 127); and high, greater than or equal to0.014 µg/L (n = 46). We evaluated the composite endpoint of AF recurrence or MACE (including death, stroke, acute coronary syndrome, and heart failure hospitalization) after the ablation. The median hs-TnT level was 0.008 µg/L. The values of chronic kidney disease prevalence, CHA DS -VASc score, B-type natriuretic peptide level, and left atrial diameter were the highest in the high hs-TnT group among the three groups. During a mean follow-up of 15 ± 8 months, AF recurrence and MACE occurred in 56 (25%) and 9 (4%) patients, respectively. The high hs-TnT group had the highest incidence of AF recurrence and MACE among the three groups (high: 39% and 15%, medium: 22% and 2%, and low: 19% and 0%, respectively; log-rank P < .05). In multivariate analysis, hs-TnT greater than or equal to 0.014 µg/L and persistent AF were independent predictors of the composite endpoint.
Hs-TnT may be a useful marker for predicting AF recurrence or MACE after AF ablation.
本研究旨在评估高敏肌钙蛋白 T(hs-TnT)在预测房颤消融后房颤复发和主要不良心血管事件(MACE)中的作用。
共纳入 227 例连续的房颤患者(平均年龄 66±10 岁;持续性房颤 98 例),均接受初始消融治疗。我们在房颤消融前测量了 hs-TnT,并根据 hs-TnT 水平将患者分为三组:低 hs-TnT 组(≤0.005µg/L,n=54)、中 hs-TnT 组(0.006-0.013µg/L,n=127)和高 hs-TnT 组(≥0.014µg/L,n=46)。我们评估了消融后房颤复发或 MACE(包括死亡、卒、急性冠脉综合征和心力衰竭住院)的复合终点。中位 hs-TnT 水平为 0.008µg/L。在三组中,高 hs-TnT 组的慢性肾脏病患病率、CHA2DS2-VASc 评分、B 型利钠肽水平和左心房直径最高。在平均 15±8 个月的随访期间,56 例(25%)和 9 例(4%)患者分别发生房颤复发和 MACE。三组中,高 hs-TnT 组房颤复发和 MACE 的发生率最高(高 hs-TnT 组:39%和 15%,中 hs-TnT 组:22%和 2%,低 hs-TnT 组:19%和 0%;log-rank P<0.05)。多变量分析显示,hs-TnT 大于等于 0.014µg/L 和持续性房颤是复合终点的独立预测因素。
hs-TnT 可能是预测房颤消融后房颤复发或 MACE 的有用标志物。