Abstract 20257: A Sensitive Cardiac Troponin T Assay In Cardiac Allograft Recipients
Although improvements have been made in the prevention and treatment of acute transplant rejection and infection, first year mortality still limits the success of heart transplantation. In addition, beside cancer accelerated cardiac allograft vasculopathy (CAV) still limits the long-term survival after heart transplantation. However, an adequate marker remains to be elucidated. The study used a high sensitivity cardiac troponin T (hsTNT) assay to determine the concentration of cardiac troponin T in 514 serum samples from 108 cardiac allograft recipients and 40 healthy controls.Results of the assay were analyzed in relation to first year mortality and the prevalence of CAV during a follow-up period of 5 years. To evaluate the value of hsTNT serum levels for the first year mortality, hsTNT was measured 4–6 weeks and 6 month after transplantation as well as two weeks before death. Median hsTNT serum level was 156±203pg/ml 4–6 weeks after transplantation, but showed a significant decrease to 39±21pg/ml after 6 month (p=0.02). In the last serum probe before death median hsTNT serum level showed a significant increase up to 89±74pg/ml (p=0.03). In addition, hsTNT serum levels 4–6 weeks after transplantation showed a strong association to cardiac allograft recipients who died within the first year compared to long term survivals after transplantation (156pg/ml±203 vs. 29pg/ml±21, p=0.001). Moreover, longitudinal analysis of hsTNT serum levels, which were measured once a year, showed an association with patients with a CAV compared to cardiac recipients without a CAV. Patients with a CAV had significantly higher serum levels of hsTNT (all p<0.05). Cardiac troponin T concentrations as measured with a highly sensitive assay provide a strong prognostic value for high risk patients after transplantation to die within the first year and aid in non-invasive monitoring for CAV in cardiac allograft recipients.
- © 2010 by American Heart Association, Inc.