Incidence and Impact of Routine Inflammatory Parameters on Outcome after Transcatheter Aortic Valve Replacement
Background. Previous research reported adverse clinical outcomes in association with systemic inflammation (SI) after transcatheter aortic valve replacement (TAVR). However, data characterizing the impact of SI, as reflected by postprocedural routine inflammatory parameters (pRIP), on clinical outco...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
|
| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2021/6628405 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849410972133883904 |
|---|---|
| author | Polykarpos C Patsalis Assem Aweimer Henrik Scharkowski Dritan Useini Peter Lukas Haldenwang Justus Thomas Strauch Ali Canbay Andreas Mügge Antonios Katsounas |
| author_facet | Polykarpos C Patsalis Assem Aweimer Henrik Scharkowski Dritan Useini Peter Lukas Haldenwang Justus Thomas Strauch Ali Canbay Andreas Mügge Antonios Katsounas |
| author_sort | Polykarpos C Patsalis |
| collection | DOAJ |
| description | Background. Previous research reported adverse clinical outcomes in association with systemic inflammation (SI) after transcatheter aortic valve replacement (TAVR). However, data characterizing the impact of SI, as reflected by postprocedural routine inflammatory parameters (pRIP), on clinical outcome of patients undergoing TAVR are sparse. Objectives. In light of this, the present work aimed to analyze incidence and clinical significance of pRIP after transapical (TA) and transfemoral (TF)-TAVR. Methods and Results. Data of 81 high-risk consecutive patients undergoing TAVR in our center from 2017 to 2018 were analyzed in a retrospective manner. 40 out of 81 patients (49, 4%) were treated via TF access (group A) and 41 patients via TA access (group B). Incidence, cause, and amplitude of pRIP were analyzed in relation to pre- and peri-interventional data. Assessment of outcomes was conducted according to the valve academic research consortium (VARC-2). Postprocedural C-reactive protein (pCRP) and leucocytes (pL) were significantly increased in patients undergoing TA-TAVR (group B) vs. TF-TAVR (group A; 12.1 ± 9.7 vs. 22.1 ± 7.9 mg/dl, p < 0.001 and 12.8 ± 4.0 vs. 14.2 ± 3.8/nl, p = 0.002); however, there was no significant difference regarding incidence of postprocedural fever (pF) ≥38.0°C (12.5% vs. 22%, p = 0.37). Furthermore, we observed a vast (though insignificant) trend towards a longer fever duration in group B vs. group A (9.9 ± 14.9 vs. 3.2 ± 5.9 hours, p = 0.06). Further analysis identified pCRP >30 mg/dl (hazard ratio (HR) 3.15, confidence interval (CI) 1.22–8.14, p = 0.018) and European System for Cardiac Operative Risk Evaluation (logistic EuroSCORE I (ES)) >20% (HR 2.95, CI 1.17–7.47, p = 0.02) as predictors of mortality; in this context, we also discovered a marginally significant trend for pL > 14/nl (HR 2.44, CI 0.97–6.14, p = 0.05). Multivariate analysis by use of the fisher`s exact test revealed a significant association between pCRP >30 mg/dl and ES >20% (p < 0.001). Conclusion. pRIP are significantly increased in patients undergoing TA-TAVR. pCRP >30 mg/dl, ES>20%, and pL > 14/nl are hallmark of adverse prognosis and require further investigation. |
| format | Article |
| id | doaj-art-5f93d462c52147ec8fa57d765078c91a |
| institution | Kabale University |
| issn | 0896-4327 1540-8183 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj-art-5f93d462c52147ec8fa57d765078c91a2025-08-20T03:34:56ZengWileyJournal of Interventional Cardiology0896-43271540-81832021-01-01202110.1155/2021/66284056628405Incidence and Impact of Routine Inflammatory Parameters on Outcome after Transcatheter Aortic Valve ReplacementPolykarpos C Patsalis0Assem Aweimer1Henrik Scharkowski2Dritan Useini3Peter Lukas Haldenwang4Justus Thomas Strauch5Ali Canbay6Andreas Mügge7Antonios Katsounas8Department of Cardiology and Angiology, University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, GermanyDepartment of Cardiology and Angiology, University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, GermanyDepartment of Cardiology and Angiology, University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, GermanyDepartment of Cardiothoracic Surgery, University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, GermanyDepartment of Cardiothoracic Surgery, University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, GermanyDepartment of Cardiothoracic Surgery, University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, GermanyDepartment of Medicine, Knappschaft University Hospital, Ruhr University Bochum, Bochum, GermanyDepartment of Cardiology and Angiology, University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, GermanyDepartment of Medicine, Knappschaft University Hospital, Ruhr University Bochum, Bochum, GermanyBackground. Previous research reported adverse clinical outcomes in association with systemic inflammation (SI) after transcatheter aortic valve replacement (TAVR). However, data characterizing the impact of SI, as reflected by postprocedural routine inflammatory parameters (pRIP), on clinical outcome of patients undergoing TAVR are sparse. Objectives. In light of this, the present work aimed to analyze incidence and clinical significance of pRIP after transapical (TA) and transfemoral (TF)-TAVR. Methods and Results. Data of 81 high-risk consecutive patients undergoing TAVR in our center from 2017 to 2018 were analyzed in a retrospective manner. 40 out of 81 patients (49, 4%) were treated via TF access (group A) and 41 patients via TA access (group B). Incidence, cause, and amplitude of pRIP were analyzed in relation to pre- and peri-interventional data. Assessment of outcomes was conducted according to the valve academic research consortium (VARC-2). Postprocedural C-reactive protein (pCRP) and leucocytes (pL) were significantly increased in patients undergoing TA-TAVR (group B) vs. TF-TAVR (group A; 12.1 ± 9.7 vs. 22.1 ± 7.9 mg/dl, p < 0.001 and 12.8 ± 4.0 vs. 14.2 ± 3.8/nl, p = 0.002); however, there was no significant difference regarding incidence of postprocedural fever (pF) ≥38.0°C (12.5% vs. 22%, p = 0.37). Furthermore, we observed a vast (though insignificant) trend towards a longer fever duration in group B vs. group A (9.9 ± 14.9 vs. 3.2 ± 5.9 hours, p = 0.06). Further analysis identified pCRP >30 mg/dl (hazard ratio (HR) 3.15, confidence interval (CI) 1.22–8.14, p = 0.018) and European System for Cardiac Operative Risk Evaluation (logistic EuroSCORE I (ES)) >20% (HR 2.95, CI 1.17–7.47, p = 0.02) as predictors of mortality; in this context, we also discovered a marginally significant trend for pL > 14/nl (HR 2.44, CI 0.97–6.14, p = 0.05). Multivariate analysis by use of the fisher`s exact test revealed a significant association between pCRP >30 mg/dl and ES >20% (p < 0.001). Conclusion. pRIP are significantly increased in patients undergoing TA-TAVR. pCRP >30 mg/dl, ES>20%, and pL > 14/nl are hallmark of adverse prognosis and require further investigation.http://dx.doi.org/10.1155/2021/6628405 |
| spellingShingle | Polykarpos C Patsalis Assem Aweimer Henrik Scharkowski Dritan Useini Peter Lukas Haldenwang Justus Thomas Strauch Ali Canbay Andreas Mügge Antonios Katsounas Incidence and Impact of Routine Inflammatory Parameters on Outcome after Transcatheter Aortic Valve Replacement Journal of Interventional Cardiology |
| title | Incidence and Impact of Routine Inflammatory Parameters on Outcome after Transcatheter Aortic Valve Replacement |
| title_full | Incidence and Impact of Routine Inflammatory Parameters on Outcome after Transcatheter Aortic Valve Replacement |
| title_fullStr | Incidence and Impact of Routine Inflammatory Parameters on Outcome after Transcatheter Aortic Valve Replacement |
| title_full_unstemmed | Incidence and Impact of Routine Inflammatory Parameters on Outcome after Transcatheter Aortic Valve Replacement |
| title_short | Incidence and Impact of Routine Inflammatory Parameters on Outcome after Transcatheter Aortic Valve Replacement |
| title_sort | incidence and impact of routine inflammatory parameters on outcome after transcatheter aortic valve replacement |
| url | http://dx.doi.org/10.1155/2021/6628405 |
| work_keys_str_mv | AT polykarposcpatsalis incidenceandimpactofroutineinflammatoryparametersonoutcomeaftertranscatheteraorticvalvereplacement AT assemaweimer incidenceandimpactofroutineinflammatoryparametersonoutcomeaftertranscatheteraorticvalvereplacement AT henrikscharkowski incidenceandimpactofroutineinflammatoryparametersonoutcomeaftertranscatheteraorticvalvereplacement AT dritanuseini incidenceandimpactofroutineinflammatoryparametersonoutcomeaftertranscatheteraorticvalvereplacement AT peterlukashaldenwang incidenceandimpactofroutineinflammatoryparametersonoutcomeaftertranscatheteraorticvalvereplacement AT justusthomasstrauch incidenceandimpactofroutineinflammatoryparametersonoutcomeaftertranscatheteraorticvalvereplacement AT alicanbay incidenceandimpactofroutineinflammatoryparametersonoutcomeaftertranscatheteraorticvalvereplacement AT andreasmugge incidenceandimpactofroutineinflammatoryparametersonoutcomeaftertranscatheteraorticvalvereplacement AT antonioskatsounas incidenceandimpactofroutineinflammatoryparametersonoutcomeaftertranscatheteraorticvalvereplacement |