Evidence map›Paper›PMID 41284049›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2026

Time- and dose-dependent high-sensitivity cardiac troponin-T to improve outcome prediction after TAVI: a multicenter cohort study.

Thorald Stolte, Jakob Johannes Reichl, Pedro Lopez-Ayala, Ivo Strebel, Felix Goetzinger, Max Wagener, Jasper Boeddinghaus, Gregor Leibundgut, Ramona Schmitt, Dirk Westermann and 6 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

16 authors.

Thorald Stolte *Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Jakob Johannes Reichl *Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Pedro Lopez-AyalaDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Ivo StrebelDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Felix GoetzingerDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Max WagenerDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Jasper BoeddinghausDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Gregor LeibundgutDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Ramona SchmittDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Südring 15, 79189, Bad Krozingen, Germany.
Dirk WestermannDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Südring 15, 79189, Bad Krozingen, Germany.
Tau HartikainenDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Südring 15, 79189, Bad Krozingen, Germany.
Christian MuellerDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Felix MahfoudDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.
Philipp RuileDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Südring 15, 79189, Bad Krozingen, Germany.
Philipp BreitbartDepartment of Cardiology and Angiology, Medical Center, Faculty of Medicine, University of Freiburg, University of Freiburg, Südring 15, 79189, Bad Krozingen, Germany.
Thomas NestelbergerDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland. thomas.nestelberger@usb.ch.ORCID http://orcid.org/0000-0003-2173-5738

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPre- and post-procedural high-sensitivity cardiac troponin T (hs-cTnT) detects periprocedural myocardial injury (PPMI) and predicts adverse outcomes following transcatheter aortic valve implantation (TAVI). Current diagnosis of PPMI relies on fixed cutoffs, lacking the integration of time- and dose-dependent effects of hs-cTnT. This limits the precision of risk stratification and subsequent patient management.

aimsTo investigate the non-linear and time-dependent effects of pre- and post-procedural hs-cTnT levels on outcomes after TAVI, these findings were compared to the dichotomized definition of PPMI proposed by the Valve Academic Research Consortium-3 (VARC-3).

methodsConsecutive patients undergoing TAVI between 2011 and 2024 at two tertiary university hospitals with available hs-cTnT measurements were enrolled. The primary outcome was all-cause mortality at 1 year. Multivariable Cox proportional hazards models were fitted. To relax the proportional hazards assumption, allowing for hazard ratios (HRs) to vary over time and across hs-cTnT values, a Royston-Parmar model was fitted.

resultsAmong 5158 patients, the HR for all-cause mortality at 1 year associated with VARC-3 defined PPMI was not statistically significant. Continuous variable analysis showed that both higher pre- and post-procedural hs-cTnT levels correlated with increased all-cause mortality risk at 1 year. Time-dependent models revealed the hazard to be greatest for higher hs-cTnT levels early post-procedurally and to decline over time.

conclusionsThe dichotomized VARC-3 definition of PPMI showed no prognostic value. Modelling hs-cTnT as continuous and time-dependent revealed a dynamic risk trajectory after TAVI. Incorporating these non-linear and time-dependent effects into risk prediction models may improve clinical decision-making and personalize post-procedural surveillance.

Indexed as

Aortic Valve StenosisPostoperative ComplicationsTranscatheter Aortic Valve ReplacementTroponin TAgedAged, 80 and overBiomarkersFemaleFollow-Up StudiesGermanyHumansMalePredictive Value of TestsPrognosisRetrospective StudiesRisk AssessmentBiomarkersTroponin TAortic stenosisHigh-sensitivity cardiac troponin TPeriprocedural myocardial injuryTranscatheter aortic valve implantation

Identifiers

PMID41284049
PMCPMC13249652

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