Prognostic value of high-sensitive troponin T for predicting cardiovascular events after atrial fibrillation ablation

摘要

Background and Objectives 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. Methods and Results 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 mu g/L (n = 54); medium, 0.006-0.013 mu g/L (n = 127); and high, greater than or equal to0.014 mu g/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 mu g/L. The values of chronic kidney disease prevalence, CHA(2)DS(2)-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 mu g/L and persistent AF were independent predictors of the composite endpoint. Conclusion Hs-TnT may be a useful marker for predicting AF recurrence or MACE after AF ablation.