title: Cardiac troponin I release after transcatheter closure of the interatrial septum: a prospective study.
abstract: OBJECTIVE
  To identify cTnI rise after percutaneous ISD closure and to determine its prognostic significance.
  
  
  BACKGROUND
  Cardiac troponin-I (cTnI) is a very specific and sensitive marker of myocardial injury. A significant increase of cTnI levels after percutaneous interatrial septal defect (ISD) closure has been reported.
  
  
  METHODS
  Patients admitted for transcatheter atrial septal defect (ASD) and patent foramen ovale (PFO) closure, were enrolled in this prospective study. Standard protocol was unchanged, except for blood sampling, to which serial cTnI before, 6, and 24 hours after the procedure was added.
  
  
  RESULTS
  Seventy-eight patients (female/male 37/41, mean age 55 +/- 13 y, 14 ASD and 64 PFO) were included. In none of the patients cTnI was elevated before the procedure and in no patients a cTnI rise above the WHO-criteria for myocardial infarction (> = 0.4 ng/ml) was seen. However, in 32 patients (41%) minimal cTnI rise (range from 0.04 ng/ml to 0.37 ng/ml) was present within a time frame of 24 hours. The increase in cTnI was not related to peri-procedural complications and to short-term outcome (mean follow-up time of 7 +/- 5 months). In addition, cTnI rise was significantly related with the presence of hyperlipideamia (P = 0.004), device size (P = 0.008), and the absence of balloon sizing (P = 0.017).
  
  
  CONCLUSIONS
  Transcatheter closure of ISD seems to be a safe procedure. A minimal but significant increase of cTnI is noted in some patients after the procedure, but it seems not to be related to short-term prognosis. However, cTnI rise is clearly associated with patients' characteristics and peri-procedural variables.
authors.affiliation: Department of Cardiology, AZ Middelheim, Antwerpen, Belgium. Tom.vydt@skynet.be
authors.forename: Tom
authors.initials: T
authors.lastname: Vydt
authors.forename: Paul
authors.initials: P
authors.lastname: Vermeersch
authors.forename: Bruno
authors.initials: B
authors.lastname: Schwagten
authors.forename: Werner
authors.initials: W
authors.lastname: Budts
mesh_terms: D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D005260:Female; D054092:Foramen Ovale, Patent / Q000628:therapy*; D006344:Heart Septal Defects, Atrial / Q000503:physiopathology / Q000628:therapy*; D006346:Heart Septum / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D019210:Troponin I / Q000032:analysis / Q000502:physiology*
chemical_list: D019210:Troponin I