Author + information
- Stephan Haussig,
- Felix Woitek,
- Norman Mangner,
- Sergey Leontyev,
- David Holzhey,
- Friedrich Mohr,
- Gerhard Schuler and
- Axel Linke
Background: Transcatheter aortic valve replacement (TAVR) enables treatment of inoperable and higher risk patients with severe aortic stenosis. Increased creatinine kinase-myocardial band (CK-MB) levels indicate myocardial injury and may predict a poorer outcome after TAVR. Aim of this study was to evaluate the impact of myocardial injury on the outcome after TAVR in a prospective single center registry.
Methods: Patients with severe aortic stenosis in which TAVR was performed between 2006 and 2014 were included into the analysis. CK-MB levels were measured at baseline and at 6, 12, and 24 hours after TAVR. Myocardial injury was defined as elevated CK-MB values above the upper normal limit (99th percentile values in a healthy population). Echocardiography was performed at baseline, 30 days, and at one year; 30-day, 1-year, and 2-year mortality was calculated.
Results: Between January 2006 and September 2014 a total of 1822 consecutive patients (Age 80.3±5.9 years, Logistic EuroScore 19.3±13.2%, STS PROM 8.3±6.0%) with severe aortic stenosis were treated with TAVR at our institution. CK-MB values after TAVR were available for 1495 patients. After TAVR 1171 patients had no elevated CK-MB values, 264 patients had 1-2 fold elevated CK-MB levels, and 60 patients had more than 2-fold elevated CKMB levels.
Patients with 1-2 fold and more than 2-fold increased CK-MB levels showed significantly higher mortality rates compared to patients with no elevated CK-MB values at 30 days (10.6% and 18.3% vs. 3.2%, p<0.001), at one year (27.0% and 39.3% vs. 15.8%, p<0.001), and at 2 years (31.6% and 43.3% vs. 20.5%, p<0.001), respectively.
Conclusions: Myocardial injury indicated by increased CK-MB levels after TAVR were found in 22% of the patients. A higher degree of myocardial injury was associated with an increased 30-day, 1-year and 2-year mortality.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: TAVR 2
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1195-187
- 2017 American College of Cardiology Foundation