{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T13:46:06Z","timestamp":1789911966475,"version":"4.0.1"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,2,23]]},"abstract":"\n Background<\/jats:title>\n \n Biomarkers of myocardial injury increase frequently during transcatheter aortic valve implantation (\n TAVI<\/jats:styled-content>\n ). The impact of postprocedural cardiac troponin (\n cT<\/jats:styled-content>\n n) elevation on short\u2010term outcomes remains controversial, and the association with long\u2010term prognosis is unknown.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We evaluated 577 consecutive patients with severe aortic stenosis treated with\n TAVI<\/jats:styled-content>\n between 2007 and 2012. Myocardial injury, defined according to the Valve Academic Research Consortium (\n VARC<\/jats:styled-content>\n )\u20102 as post\u2010\n TAVI<\/jats:styled-content>\n cardiac troponin T (cTnT) >15\u00d7 the upper limit of normal, occurred in 338 patients (58.1%). In multivariate analyses, myocardial injury was associated with higher risk of all\u2010cause mortality at 30\u00a0days (adjusted hazard ratio [\n HR<\/jats:styled-content>\n ], 8.77; 95%\n CI<\/jats:styled-content>\n , 2.07\u201337.12;\n P<\/jats:italic>\n =0.003) and remained a significant predictor at 2\u00a0years (adjusted\n HR<\/jats:styled-content>\n , 1.98; 95%\n CI<\/jats:styled-content>\n , 1.36\u20132.88;\n P<\/jats:italic>\n <0.001). Higher\n cTnT<\/jats:styled-content>\n cutoffs did not add incremental predictive value compared with the\n VARC<\/jats:styled-content>\n \u20102\u2013defined cutoff. Whereas myocardial injury occurred more frequently in patients with versus without coronary artery disease (\n CAD<\/jats:styled-content>\n ), the relative impact of\n cTnT<\/jats:styled-content>\n elevation on 2\u2010year mortality did not differ between patients without\n CAD<\/jats:styled-content>\n (adjusted\n HR<\/jats:styled-content>\n , 2.59; 95%\n CI<\/jats:styled-content>\n , 1.27\u20135.26;\n P<\/jats:italic>\n =0.009) and those with\n CAD<\/jats:styled-content>\n (adjusted\n HR<\/jats:styled-content>\n , 1.71; 95%\n CI<\/jats:styled-content>\n , 1.10\u20132.65;\n P<\/jats:italic>\n =0.018;\n P<\/jats:italic>\n for interaction=0.24). Mortality rates at 2\u00a0years were lowest in patients without\n CAD<\/jats:styled-content>\n and no myocardial injury (11.6%) and highest in patients with complex\n CAD<\/jats:styled-content>\n (\n SYNTAX<\/jats:styled-content>\n score >22) and myocardial injury (41.1%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n VARC<\/jats:styled-content>\n \u20102\u2013defined\n cTnT<\/jats:styled-content>\n elevation emerged as a strong, independent predictor of 30\u2010day mortality and remained a modest, but significant, predictor throughout 2\u00a0years post\u2010\n TAVI<\/jats:styled-content>\n . The prognostic value of\n cTnT<\/jats:styled-content>\n elevation was modified by the presence and complexity of underlying\n CAD<\/jats:styled-content>\n with highest mortality risk observed in patients combining\n SYNTAX<\/jats:styled-content>\n score >22 and evidence of myocardial injury.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.115.002430","type":"journal-article","created":{"date-parts":[[2016,2,20]],"date-time":"2016-02-20T01:07:46Z","timestamp":1455930466000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":50,"title":["Post\u2010Procedural Troponin Elevation and Clinical Outcomes Following Transcatheter Aortic Valve Implantation"],"prefix":"10.1161","volume":"5","author":[{"given":"Konstantinos C.","family":"Koskinas","sequence":"first","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Stortecky","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Franzone","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crochan J.","family":"O'Sullivan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabien","family":"Praz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katazyrna","family":"Zuk","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenz","family":"R\u00e4ber","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Pilgrim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aris","family":"Moschovitis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg M.","family":"Fiedler","sequence":"additional","affiliation":[{"name":"Center for Laboratory Medicine, Inselspital, University Hospital Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"J\u00fcni","sequence":"additional","affiliation":[{"name":"Institute of Primary Health Care, University of Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dik","family":"Heg","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine, University of Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Wenaweser","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Windecker","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Bern University Hospital, Bern, 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