Abstract 15819: Usefulness of High-Sensitive Troponin I for the Monitoring of Acute Cellular Rejection after Cardiac transplantation
Introduction There are conflicting data about the role of cardiac troponin I (cTnI) by conventional method for the prediction of acute rejection after heart transplantation (HTPL). The purpose of this study was to evaluate whether cTnI as measured by the early prototype high sensitive assay (hs-cTnI) can predict acute rejection episode after HTPL via comparison with grade of rejection in endomyocardial biopsy (EMB).
Methods This was a single center cross-sectional study evaluating cTnI levels using both hs-cTnI and current less sensitive or contemporary cTnI (Cont-cTnI) assays measured at the time of EMB after HTPL. We calculated an index ratio of observed cTnI to expected mean cTnI for each individual patient defined by the mean cTnI measurements at EMB, 60 days post-HTPL.
Results A total of 252 biopsies from 47 patients were included in this study. In the multivariable mixed model analysis to relate with the presence of acute rejection 60 days after HTPL, hs-cTnI level was significantly related with the presence of rejection (p=0.010). The hs-cTnI ratio index was significantly higher at the time of rejection (1.37 [1.23-2.88]) compared to those without rejection (0.90 [0.51-1.16], p<0.001, Figure A). In receiver operating characteristic curve analysis, an hs-cTnI ratio index of ≥1.17 could predict the acute rejection with a sensitivity of 82.4% and a specificity of 77.1% (figure B and C).
Conclusion An increased hs-cTnI ratio index was significantly related to rejection episodes, serial monitoring of hs-cTnI and comparing it with the values without rejection might be useful for the detection of acute rejection after HTPL.
- © 2012 by American Heart Association, Inc.