Management of Systemic Inflammatory Response Syndrome After Cardiovascular Interventions. Diagnostic, Prognostic, and Therapeutic Implications

Mannina, Carlo; Kini, Annapoorna; Carbone, Andreina; Neibart, Eric; Bossone, Eduardo; Prandi, Francesca Romana; Tadros, Rami; Esposito, Giovanni; Erbel, Raimund; Sharma, Samin K.; Lerakis, Stamatios

doi:10.1016/j.amjcard.2024.04.007

The American Journal of Cardiology

2024

DOI: 10.1016/j.amjcard.2024.04.007

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Management of Systemic Inflammatory Response Syndrome After Cardiovascular Interventions. Diagnostic, Prognostic, and Therapeutic Implications

Carlo Mannina,

Annapoorna Kini,

Andreina Carbone

et al.

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2024

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Association of Systemic Inflammatory Response Syndrome With Cardiovascular Events After Mitral Transcatheter Edge‐to‐Edge Repair

Mannina,

Sharma,

Carbone

et al. 2024

JAHA

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Background Systemic inflammatory response syndrome (SIRS) following cardiovascular interventions is associated with adverse events during hospitalization and follow‐up. Mitral transcatheter edge‐to‐edge repair is increasingly utilized for treatment of mitral regurgitation (MR). We investigated whether SIRS following mitral transcatheter edge‐to‐edge repair may occur and be associated with adverse clinical outcomes. Methods and Results A total of 158 consecutive patients with severe MR undergoing mitral transcatheter edge‐to‐edge repair were studied. SIRS was defined by leukocytosis (≥12 × 10 9 /L) and fever (≥38 °C) within 48 hours after intervention. Baseline inflammation was measured by absolute neutrophil and lymphocyte counts and neutrophil‐lymphocyte ratio. The primary end point of major cardiovascular events was the composite of nonfatal myocardial infarction, nonfatal stroke, and all‐cause death. Recurrent MR at follow‐up was also recorded. The mean patient age was 80.8±8.8 years. Forty‐four (27.9%) developed SIRS. Neutrophil‐lymphocyte ratio correlated with onset of leukocytosis and fever ( P =0.04). During a median follow‐up of 12.5 (5.4–17.4) months, the primary end point occurred in 27 (17.1%) patients (6 myocardial infarction, 5 strokes, and 16 deaths). Patients with SIRS more often had severe MR (79.5% versus 62.7%, P =0.02) at follow‐up. After adjustment for pertinent variables, SIRS (HR 2.73 [95% CI, 1.08–6.86]; P =0.03) was independently associated with major cardiovascular events. Conclusions SIRS after mitral transcatheter edge‐to‐edge repair is a strong independent predictor of major cardiovascular events. Closer follow‐up is warranted because patients with SIRS have more severe MR at follow‐up.

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Association of Systemic Inflammatory Response Syndrome With Cardiovascular Events After Mitral Transcatheter Edge‐to‐Edge Repair

Mannina,

Sharma,

Carbone

et al. 2024

JAHA

View full text Add to dashboard Cite

show abstract

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Management of Systemic Inflammatory Response Syndrome After Cardiovascular Interventions. Diagnostic, Prognostic, and Therapeutic Implications

Cited by 1 publication

References 62 publications

Association of Systemic Inflammatory Response Syndrome With Cardiovascular Events After Mitral Transcatheter Edge‐to‐Edge Repair

Association of Systemic Inflammatory Response Syndrome With Cardiovascular Events After Mitral Transcatheter Edge‐to‐Edge Repair

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