Determinants of elevation of high sensitivity cardiac troponin T after an atrial septal defect percutaneous closure

Alejandro E. Contreras, Servicio de Cardiología Pediátrica y Cardiopatías Congénitas del Niño y Adulto, Hospital Privado Universitario de Córdoba, Facultad de Medicina, Instituto Universitario de Ciencias Biomédicas de Córdoba, Argentina
Alejandro R. Peirone, Servicio de Cardiología Pediátrica y Cardiopatías Congénitas del Niño y Adulto, Hospital Privado Universitario de Córdoba, Facultad de Medicina, Instituto Universitario de Ciencias Biomédicas de Córdoba, Argentina
Ernesto Juaneda, Servicio de Cardiología Pediátrica y Cardiopatías Congénitas del Niño y Adulto, Hospital Privado Universitario de Córdoba, Facultad de Medicina, Instituto Universitario de Ciencias Biomédicas de Córdoba, Argentina
Víctor Defagó, Servicio de Pediatría, Hospital Privado Universitario de Córdoba. Córdoba, Argentina
Eduardo Cuestas, Servicio de Pediatría, Hospital Privado Universitario de Córdoba. Córdoba, Argentina

Objectives: The aim was to determine the relationship between the elevation of ultrasensitive troponin T (hs-cTnT) after percutaneous atrial septal defect (ASD) closure with deficient aortic rim and with standard and specific maneuvers of the intervention. Method: Baseline hs-cTnT was measured and repeated 6 hours after the procedure. To determine the influence of independent variables with the dependent variable (change in hs-cTnT), a generalized linear mixed model was used. Results: The total cohort consisted in 106 patients. The median age was 8 years, and 22 patients (21%) were older than 18 years. The hs-TnT before the procedure was 3.7 pg/ml and 6 hours after the intervention was finalized was 72.5 pg/ml. The hs-TnT at 6 hours was similar in patients with sufficient vs. deficient aortic rim. A generalized linear mixed model demonstrated a direct relationship between hs-cTnT change and ASD diameter (β: 2.8; CI: 0.8 to 4.9; p < 0.01) and fluoroscopy time (β: 2.7; CI: 0.6 to 4.7; p < 0.01) and an inverse relationship between hs-cTnT change and patient weight (β: –0.7; CI: –1.1 to –0.3; p < 0.01). Conclusions: The increase in hs-cTnT after percutaneous ASD treatment was directly related to ASD diameter and the fluoroscopy time and inversely to the patient weight. Aortic rim deficit was not associated with elevation of hs-cTnT.

Keywords: Heart septal defects. Atrial. Cardiac catheterization. Percutaneous closure. Troponin.