AUTHOR=Wang Xiaoyan , Chen Xueying , Ye Yong , Peng Juan , Lin Jinyi , Deng Xin , Lin Li , You Jieyun , Wang Xingxu , Zhou Daxin , Chen Qingxing , Ge Junbo 

TITLE=Troponin T Elevation After Percutaneous Left Atrial Appendage Occlusion

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.721224

DOI=10.3389/fcvm.2021.721224

ISSN=2297-055X

ABSTRACT=Background: Cardiac Troponin T (cTNT) has been widely used in detecting cardiac damage. Elevated cTNT level has been reported to be associated with increase ed mortality in multiple cardiac conditions. It is not uncommon to observe an increased level of cTNT in patients after left atrial appendage occlusion (LAAO). The objective of the study is to study the incidence, significance, and factors associated with cardiac troponin T (cTNT) elevation after LAAO.
Methods: We prospectively included patients who underwent LAAO from January 2019 to July 2020 in Fudan Zhongshan hospital. Patients were divided into those with elevated cTNT after procedure and those with normal post-procedure cTNT. All individuals were followed up for 1 year. The primary outcome is major adverse cardiovascular events, which include myocardial infarction, heart failure, cardiac death, stroke. The second outcome is peri-procedure complication, including chest pain, tachycardia, cardiac tamponade, change of electrocardiograph, atrial thrombus.
Results: A total of 190 patients were enrolled. 85.3% of the patients had elevated cTNT after LAAO while 14.7% of them did not. Exposure time, dosage of contrast, types of devices, shapes and sizes of LAA could contribute to elevated post-procedure cTNT. We found that patients with Watchman device were more likely to have elevated post-procedure cTNT than those with Lambre device (89.2% vs. 76.7%, p=0.029). LAAO shapes were associated with cTNT levels in patients with Watchman device, while  diameter of outer disc and LAA depth mattered for Lambre device. There was no significant difference in the primary and second outcome between the 2 groups (P-Value: 0.619, 0.674).
Conclusion: LAAO was found to be commonly accompanied with cTNT elevation, which might not to be related to the complications and adverse cardiac outcomes within 1-year of follow-up. More over, eGFR at baseline, exposure time, dosage of contrast, types of LAAO device and LAA morphology could contribute to cTNT elevation.