Effect on Mortality of Systemic Thromboinflammatory Response After Transcatheter Aortic Valve Implantation

Kalińczuk, Łukasz; Zieliński, Kamil; Chmielak, Zbigniew; Mintz, Gary S.; Dąbrowski, M; Pręgowski, Jerzy; Proczka, Michał; Michałowska, Ilona; Czerwińska-Jelonkiewicz, Katarzyna; Łazarczyk, Hubert; Demkow, Marcin; Hryniewiecki, Tomasz; Witkowski, Adam

doi:10.1016/j.amjcard.2019.08.036

Cited by 8 publications

(4 citation statements)

References 17 publications

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“…Several studies have demonstrated a relationship between a postprocedural platelet decrease and mortality with the TAVI procedure [28,29]. In the current study, there was no statistical significance difference in the median (IQR) platelet count decrease between survivors and nonsurvivors (108 [77-154] × 10 9 /l in Group 1 and 108 [59-141] × 10 9 /l in Group 2; P = 0.47).…”

Section: Discussioncontrasting

confidence: 62%

Association between Intermountain Risk Score and long-term mortality with the transcatheter aortic valve implantation procedure

Özdemir¹,

Esen²,

Emren³

et al. 2021

Kardiol Pol

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Background: Since its first introduction, the spectrum and frequency of use of transcatheter aortic valve implantation (TAVI) have increased throughout the world. Therefore, it is crucial to determine which patients are at high mortality risk with TAVI. The Intermountain Risk Score (IMRS) is a score calculated from laboratory parameters. This study aimed to determine the long-term mortality of TAVI patients using the IMRS and to compare it with traditional scoring systems. Methods:The study included a total of 133 patients undergoing TAVI at our hospital from 2010 to 2019. Demographic data, co-morbid diseases, echocardiographic and laboratory parameters were collected retrospectively. The performance of IMRS was assessed as compared to the mortality determined in the overall patient population.Results: During the follow-up, 54.9% of patients (60 patients) (Group 1) survived; the mortality in Group 2 (60 patients) was 45.1%. The survival period had a mean of 1433 (±124) days. The mean IMRS was 1.67 (0.7) in Group 1 and 2.33 (0.72) in Group 2 (P <0.001). In multivariable analyses, only high risk of IMRS (hazard ratio [HR], 3.430; 95% confidence interval [CI], 1.537-7.653; P = 0.003) and EuroSCORE II (HR, 1.141; 95% CI, 1.011-1.288; P = 0.03) independently predicted long-term mortality. Conclusions:From the evaluation of all laboratory and echocardiography parameters, long-term mortality (>30 days) following the TAVI procedure can be said to be higher in patients with a high IMRS. The data from this study can be considered of value in demonstrating the clinical significance of IMRS calculation before the TAVI procedure.

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Section: Discussioncontrasting

confidence: 62%

Association between Intermountain Risk Score and long-term mortality with the transcatheter aortic valve implantation procedure

Özdemir¹,

Esen²,

Emren³

et al. 2021

Kardiol Pol

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“…Increased thromboinflammatory response after TAVI is associated with poor outcomes. [13][14] This inflammatory process might be effective in the pathogenesis of AKI. Leukocyte count, C-reactive protein, and procalcitonin levels all increased after SIRS in patients as a result of the production of IL-6 and IL-8 being greatly enhanced.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10][11][12] Thromboinflammatory response after TAVI has been linked to poor outcomes in numerous studies. [13][14] To assess the thromboinflammatory response, basic whole blood parameters such as the neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume were used (MPV). The NLR has been identified as a predictive marker of systemic inflammation in a number of cardiovascular and non-cardiovascular diseases.…”

Section: Introductionmentioning

confidence: 99%

The predictive value of neutrophil to lymphocyte ratio and mean platelet volume on acute kidney injury after TAVI

Turen¹,

Yılmaz

2022

SYBD

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Objective: Transcatheter aortic valve implantation (TAVI) is an effective treatment for severe aortic stenosis. Acute kidney injury (AKI) is a common complication after TAVI. The development of AKI after TAVI has been linked to the thromboinflammatory response as evaluated by the neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV). We sought to determine the predictive value of NLR and MPV on AKI after TAVI in this study. Method: This is a single-center retrospective study. Baseline, peri-procedural, and post-procedural demographic, laboratory, and clinical characteristics were assessed for AKI. The optimal NLR and MPV cut-off values for predicting AKI were determined using receiver operating characteristic (ROC) curve analysis. Results: A total of 184 consecutive patients (age 79.4 ± 7.8 years, 61.4% female) who underwent TAVI were included in this study. The optimal cut-off points for the NLR and MPV were 5.70 (AUC: 0.790; 95% CI: 0.711-0.869, p<0.001 and sensitivity= 80.0%, specificity= 65.2%) and 9.15 fL (AUC:0.713; 95% CI: 0.629-0.997, p<0.001 and sensitivity=70.7%, specificity=63.6%), respectively. AKI occurred in 41 (22.3%) patients included in the study and 6 (3.3%) required dialysis. Baseline GFR (OR: 0.98; 95% CI: 0.94-0.99, p = 0.001), post-procedural WBC count (OR: 1.17; 95% CI: 1.03-1.33, p= 0.02), post-procedural NLR≥ 5.7 (OR: 5.16; 95% CI: 1.84-14.48, p= 0.002), and post-procedural MPV ≥ 9.15 fL (OR: 3.70; 95% CI: 1.54–8.91, p= 0.004) were found to be the independent predictors of AKI after TAVI in multivariable analysis. Conclusion: Post-procedural NLR and MPV were found to be independent predictors of AKI after TAVI.

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“…The TAVR procedure was performed [10] with either a self-expandable supra-annular device -early generation CoreValve or newer generation Evolut-R/-Pro (CoreValve ReValving Technology, Medtronic, Inc., Minneapolis, MN, US); Acurate neo (Boston Scientific Corporation, Maple Grove, MN, US); or Engager (Medtronic, Inc., Minneapolis, MN, US); a balloon expandable early generation Edwards SAPIEN or newer generation SAPIEN XT/3 (Edwards Lifesciences, Irvine, CA, US); or new generation self-deployed intra-annular Lotus Edge Aortic Valve System (Boston Scientific Corporation) [11]. TAVR procedural characteristics were prospectively collected.…”

Section: Methodsmentioning

confidence: 99%

Prognostic value of computed tomography derived measurements of pulmonary artery diameter for long-term outcomes after transcatheter aortic valve replacement

et al. 2022

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Background: An increase in pulmonary artery diameter (PAD) on multi-detector computed tomography (MDCT) may indicate pulmonary hypertension. We assessed the prognostic value of MDCT-derived measurements of PAD on outcomes after successful transcatheter aortic valve replacement (TAVR).Methods: Consecutive patients treated with TAVR from February 2013 to October 2017, with a 68.8% rate of new generation valves, underwent pre-interventional MDCT with measurements of PAD (in the widest short-axis within 3 cm of the bifurcation) and ascending aortic diameter (AoD; at the level of the PAD). The PAD/AoD ratio was calculated. Patients with high-density lipoprotein cholesterol levels ≤46 mg/dl and C-reactive protein levels ≥0.20 mg/dl at baseline were identified as the frail group. One-year mortality was established for all subjects.Results: Among studied 266 patients (median age, 82.0 years; 63.5% women) those who died at 1 year (n = 34; 12.8%) had larger PAD and PAD/AoD (28.9 [5.0] vs. 26.5 [4.6] mm and 0.81 [0.13] vs. 0.76 [0.13] mm vs. the rest of the studied subjects; P = 0.005 and P = 0.02, respectively) but similar AoD. The cutoff value for the PAD to predict 1-year mortality was 29.3 mm (sensitivity, 50%; specificity, 77%; area under the curve, 0.65). Patients with PAD >29.3 mm (n = 72; 27%) had higher 1-year mortality (23.6% vs. 8.8%, log-rank P = 0.001). Baseline characteristics associated with PAD >29.3 mm were a bigger body mass index, more frequent diabetes mellitus, more prior stroke/transient ischemic attacks and atrial fibrillation, and lower baseline maximal aortic valve gradient with higher pulmonary artery systolic pressure (PASP). PAD >29.3 mm and frailty, but not baseline PASP, remained predictive of 1-year mortality in the multivariable model (hazard ratio [HR], 2.221; 95% CI, 1.038-4.753; P = 0.04 and HR, 2.801; 95% CI, 1.328-5.910; P = 0.007, respectively).Conclusion: PAD >29.3 mm on baseline MDCT is associated with higher 1-year mortality after TAVR, independently of echocardiographic measures of PH and frailty.

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Effect on Mortality of Systemic Thromboinflammatory Response After Transcatheter Aortic Valve Implantation

Cited by 8 publications

References 17 publications

Association between Intermountain Risk Score and long-term mortality with the transcatheter aortic valve implantation procedure

Association between Intermountain Risk Score and long-term mortality with the transcatheter aortic valve implantation procedure

The predictive value of neutrophil to lymphocyte ratio and mean platelet volume on acute kidney injury after TAVI

Prognostic value of computed tomography derived measurements of pulmonary artery diameter for long-term outcomes after transcatheter aortic valve replacement

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