Abstract 17157: Chronic Troponin I Leak After Heart Transplantation: What is its Meaning?
Introduction: Elevations in serum troponin I (cTnI) have been noted to reflect myocardial injury in non-transplant patients. Chronic cTnI leaks are also known to occur at various times in certain heart transplant patients; it is suggested that these patients have poor outcome. We sought to assess outcomes of patients with increased serum concentrations in cTnI within the first year post-heart transplantation.
Methods: Between 2010 and 2014 we assessed 449 heart transplant patients, 15 of which had cTnl leak. Chronic cTnl leak was defined as elevated serum cTnl ≥ 0.05 ng/ml for a duration ≥2 months. For these patients, subsequent 1-year survival, rejection, cardiac allograft vasculopathy (CAV) as defined by stenosis ≥ 30% by angiography and Non-Fatal Major Adverse Cardiac Events (NF-MACE: myocardial infarction, new congestive heart failure, percutaneous coronary intervention, implantable cardioverter defibrillator/pacemaker implant, stroke) were assessed. There were 38 patients who had no cTnl leak that were used as a control. These patients were also followed for the subsequent year post-transplant for the same outcome parameters as noted above.
Results: The chronic cTnl leak group compared to the no cTnl leak group had significantly reduced subsequent 1-year survival and NF-MACE. No significant difference was observed for subsequent 1-year freedom from CAV, acute cellular, antibody-mediated and biopsy negative rejection.
Conclusions: cTnl leak in heart transplant patients appears to predict poor outcome for survival and prospect of NF-MACE events. A longer follow-up period is needed to confirm these early observations.
Author Disclosures: J. Patel: Research Grant; Modest; Alexion Pharmaceuticals, Pfizer, Alnylam Pharmaceuticals. M. Kittleson: None. D. Geft: None. T. Aintablian: None. Y. Li: None. D.H. Chang: Research Grant; Modest; Teva Pharmaceutical. Other; Modest; Stock in Abbot Pharmaceuticals, Stock in AbbVie, Stock in Repligen. L. Czer: Research Grant; Modest; St. Jude Medical. F. Esmailian: None. J. Kobashigawa: Research Grant; Modest; Novartis, CareDx. Speakers Bureau; Modest; CareDx. Consultant/Advisory Board; Modest; Novartis, TransMedics.
- © 2016 by American Heart Association, Inc.