Systemic inflammatory response syndrome predicts increased mortality in patients after transcatheter aortic valve implantation

Sinning, Jan‐Malte; Scheer, Anne-Cathérine; Adenauer, Viktoria; Ghanem, Alexander; Hammerstingl, Christoph; Schueler, Robert; Müller, Cornelius; Vasa‐Nicotera, Mariuca; Grube, Eberhard; Nickenig, Georg; Werner, Nikos

doi:10.1093/eurheartj/ehs002

Cited by 141 publications

(140 citation statements)

References 38 publications

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“…29 This may explain the relation found in this and other studies between postoperative leucocyte count and AKI. 4,6,10,30 At variance with percutaneous coronary intervention (PCI), 31 we found a borderline association between contrast load and AKI in the univariable analysis, yet contrast load was not found to be an independent predictor. The absence of an association cannot be explained by a restrictive use of contrast in the present population considering the mean values and standard deviations (142±97 and 158±96 mL) although this may be an issue of sample size as a result of which a significant statistical difference was not detected.…”

Section: Discussionmentioning

confidence: 67%

Blood Transfusion and the Risk of Acute Kidney Injury After Transcatheter Aortic Valve Implantation

Nuis

Rodés‐Cabau

Sinning

et al. 2012

Circ: Cardiovascular Interventions

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Section: Discussionmentioning

confidence: 67%

Blood Transfusion and the Risk of Acute Kidney Injury After Transcatheter Aortic Valve Implantation

Nuis

Rodés‐Cabau

Sinning

et al. 2012

Circ: Cardiovascular Interventions

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129

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“…22 The occurrence of systemic inflammatory response syndrome (SIRS) was defined as fulfilling ≥2 of the following 4 criteria: body temperature <36.0°C or >38.0°C, heart rate >90 bpm, respiratory rate >20 breaths/min, or Paco 2 <32 mm Hg, leukocyte count >12 or <4 (10 9 /L) 1, 6, 24, 48, or 72 hours (E2) after TAVI. 23 Preprocedural cerebral DW-MRI was performed the day before TAVI. First, postprocedural investigations (E2) were performed 3 days after TAVI and encompassed clinical status, NIHSS, RBANS, mini-mental state examination, and cerebral DW-MRI.…”

Section: Methodsmentioning

confidence: 99%

Cognitive Trajectory After Transcatheter Aortic Valve Implantation

Ghanem

Kocurek

Sinning

et al. 2013

Circ: Cardiovascular Interventions

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Background-Transcatheter aortic valve implantation (TAVI) is known to be associated with silent cerebral injury, which could contribute to cognitive impairment. Considering its increasing use, thorough longitudinal investigation of cognitive trajectory after TAVI is pivotal. Methods and Results-Repeatable battery for the assessment of neuropsychological status was performed before (E1), 3 days (E2), 3 months (E3), 1 (E4) year, and 2 years (E5) after TAVI. Baseline characteristics, procedural data, imaging parameters of brain injury (diffusion-weighted MRI), and the use of conceivable neuroprotective approaches were investigated for their effect on cognitive function. Cognitive performance was investigated in 111 patients (mean log EuroSCORE, 30±13%). Global cognitive function (repeatable battery for the assessment of neuropsychological status total score) increased transiently at E2 (P=0.02) and was comparable with baseline levels at E3, E4, and E5. Six patients (5.4%) demonstrated early cognitive decline. Persistence and late onset were seen infrequently (n=3, 2.7% and n=4, 3.6%, respectively). Hence, early cognitive decline was ruled out in 105 patients (94.6%), and a majority of patients (91%) demonstrated sustained cognitive performance throughout all investigated time points. Interestingly, only patient age (P=0.012), but not prior cerebrovascular events, cognitive status, direct TAVI, cerebral embolism in diffusion-weighted MRI, or the use of a cerebral embolic protection device was found to be independently associated with cognitive decline, linking higher age to cognitive impairment along the first 2 years after TAVI. Conclusions-Long-term cognitive performance was preserved in the great majority (91%) of patients throughout the first 2 years after TAVI, despite the high intrinsic risk for cognitive deterioration. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00883285.(Circ Cardiovasc Interv. 2013;6:615-624.)Key Words: cognition ◼ dementia ◼ injury ◼ intracranial embolism ◼ mild cognitive impairment ◼ stroke ◼ TAVR

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“…Emerging data suggest that fever during the first 72 h after TAVI may derive from SIRS rather than an infectious cause [10]. Both sepsis and SIRS have been associated with worse outcomes following TAVI [11,12].…”

Section: Introductionmentioning

confidence: 99%

The Frequency and Prognostic Impact of Fever Following Transcatheter Aortic Valve Implantation

Orvin

Kornowski²,

Bishara³

et al. 2014

Cardiology

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Objectives: This study soughtto explore the frequency and prognostic implications of infectious and noninfectious fever following transcatheter aortic valve implantation (TAVI). Methods: We performed a retrospective cohort study including 194 consecutive patients who underwent TAVI at our institution. We identified and characterized all patients who developed fever within the first 72 h following the procedure. We determined the etiology of the fevers (infectious vs. noninfectious) and assessed their impact on in-hospital complications and 1-year mortality. Results: Following TAVI,65 (33.5%) patients had fever (mean age 83.7 ± 3.8 years, 70.2% female). An infectious etiology was evident in only 17 of the 65 patients (26.1%) with fever, mainly due to pneumonia (52.9%) and a urinary tract infection (41.2%). No significant difference was observed in baseline characteristics, the mean fever temperature/duration, or signs of inflammatory response between infectious and noninfectious fevers. The mean hospital duration was longer (7 ± 4.8 days vs. 4.7 ± 2.4 days, p = 0.01) among patients with an infectious fever; however, fever had no impact on the 1-year mortality rate (5.9 and 4.5%, respectively, p = 0.71). Conclusions: Our study demonstrates that, although fever was a common phenomenon after TAVI, it represented an infectious complication only in a minority of cases. Nevertheless, fever, infectious or not, had no impact on the 1-year mortality rate following TAVI.

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Systemic inflammatory response syndrome predicts increased mortality in patients after transcatheter aortic valve implantation

Abstract: SIRS may occur after TAVI and is a strong predictor of mortality. The development of SIRS could be easily identified by a significant increase in the leucocyte count shortly after TAVI.

Cited by 141 publications

References 38 publications

Blood Transfusion and the Risk of Acute Kidney Injury After Transcatheter Aortic Valve Implantation

Blood Transfusion and the Risk of Acute Kidney Injury After Transcatheter Aortic Valve Implantation

Cognitive Trajectory After Transcatheter Aortic Valve Implantation

The Frequency and Prognostic Impact of Fever Following Transcatheter Aortic Valve Implantation

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