Afib: cardiac troponin-T predicts incidence and recurrence after RFA

  • Bai Y & al.
  • Biomarkers
  • 10 Apr 2018

  • from Antara Ghosh
  • Clinical Summaries
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Takeaway

  • This meta-analysis suggests significant association between cardiac troponin-T (TnT) and Afib occurrence, recurrence as well as stroke/systemic embolism (SE) and major bleeding, but not mortality after radiofrequency ablation (RFA).
  • No such association was observed for cardiac troponin-I (TnI) levels.

Why this matters

  • As all patients with Afib after RFA show elevated troponin levels, its predictive power for Afib incidence and recurrence is debatable.

Study design

  • This systematic review, meta-analysis and meta-regression evaluated 27 studies associated with either incident Afib occurrence (n=13), Afib recurrence after RFA (n=8) or trend of Afib related prognosis with increased troponin levels (n=6).
  • Funding: National Science Foundation of China.

Key results

  • Incident vs no Afib was associated with significantly higher TnT levels (standardised mean differences [SMD], 3.77; P<.001; I2, 99.7%), but difference in TnI (SMD, 0.42; P=.06; I2, 87.0%) levels were non-significant.
  • Peri-ablation TnI levels (SMD, −0.61; P=.049; I2, 87.1%) were similar but TnT levels (SMD, 0.38; P=.002, I2, 64.7%) were significantly higher in patients with Afib recurrence.
  • Higher TnT levels were associated with increased risk for stroke/SE (r2, 0.93; P=.04) or major bleeding (r2, 0.99; P<.0001).
  • TnT (r2, 0.20; P=.31) or TnI (r2, 0.09; P=.25) levels were not associated with mortality.
  • No association was observed between higher TnI levels and risk for stroke/SE (r2, 0.02; P=.74) or major bleeding (r2, 0.002; P=.92).

Limitations

  • Moderate to high heterogeneity.