Pre-procedural elevated cardiac troponin predict risk of long-term all-cause mortality after transcatheter aortic valve replacement: a meta-analysis of prospective studies

Abstract

Background: The purpose of this meta-analysis was to evaluate the relationship between elevated cardiac troponin pre-transcatheter aortic valve replacement (TAVR) and long-term all-cause mortality.

Methods: Prospective studies with the endpoint of all-cause mortality were included. We primarily used the fixed-effect model weighted by inverse variance. Meta-regression and subgroup analyses were conducted to explore the potential sources of heterogeneity by specified study characteristics.

Results: Seven prospective studies comprising of 3049 subjects were included in our meta-analysis. Pre-procedural elevated cardiac troponin was associated with increased risk of long-term mortality post TAVR [hazard ratio (HR) 2.25, 95% CI 1.83–2.78, p = 0.000, I² = 30.3%, p for heterogeneity 0.197]. In addition, subgroup analyses have shown that the group with an younger age (<82 y) seemed to have a higher risk of all-cause mortality than the group with older age (≥82 y) [HR 4.08 (2.41 to 6.89) VS 2.01 (1.60 to 2.53), p = 0.016 for subgroup difference].

Conclusions: Pre-procedural elevated cardiac troponin was associated with increased long-term all-cause mortality in patients undergoing TAVR.

Keywords:

• Troponin
• myocardial injury
• TAVR
• mortality
• meta-analysis

Author Contributions

Chenghui Zhou and Yuehua Li conceived the idea and supervised the study. Yuehua Li and Hanjun Pei acquired and analyzedanalysed the data, took responsibility of the accuracy and integrity of the data. Yuehua Li drafted the manuscript. Chenghui Zhou, Yuehua Li, Ying Lou contributed to write, review, or revise the paper.

Disclosure statement

The authors have no conflicts of interest to declare.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China [no. 81970290, 81760096 and 81400271], the Inner Mongolia Natural Science Projects [no. 2015MS0858], PUMC Youth Fund and Fundamental Research Funds for the Central Universities [no. 2017320009].