High-sensitivity troponin T is a prognostic marker for patients with aortic stenosis after valve replacement surgery

Abstract

Background: Aortic stenosis (AS) is recognized as a cause of sudden cardiac death. Recently, the measurement of high-sensitivity troponin T (hs-TnT) has become possible. Several studies have clarified that hs-TnT is a marker to indicate mortality of cardiovascular diseases.

Objectives: To examine whether hs-TnT can be used as a prognostic marker to predict the operative outcome of AS.

Methods: We enrolled 60 patients with AS (mean age=68.7 ± 9.6 years, male/female=30/30). Cardiac catheterization and echocardiography were performed to evaluate the severity of AS. Aortic valve replacement surgery was performed in all patients. We defined major adverse cardiac events (MACE) as composite events of heart failure, fatal arrhythmia, and all causes of death.

Results: We followed up the patients for 922 ± 800 days. Mean left ventricular ejection fraction was 60.0 ± 1.8%. Mean aortic valve area was 0.61 ± 0.03 cm(2). MACE occurred in 11 patients (18%), including 5 sudden cardiac deaths. We divided the patients into three groups based on the percentile of the plasma levels of hs-TnT. Kaplan-Meier curve revealed a statistically significant difference in MACE rate among the groups (log-rank test, χ(2)=13.0, p=0.002). We conducted a Cox proportional hazard analysis with a model including age, sex, estimated glomerular filtration rate, and hs-TnT tertile as explanatory variables to predict MACE. We found that hs-TnT tertile to be a significant factor to predict MACE (hazard ratio: 3.71, p=0.03).

Conclusions: hs-TnT can be a prognostic marker for patients with AS after valve replacement surgery.