Incidence and Impact of Routine Inflammatory Parameters on Outcome after Transcatheter Aortic Valve Replacement

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Inflammation Research

Background:

• Systemic inflammation (SI) is linked to adverse outcomes post-transcatheter aortic valve replacement (TAVR).
• Limited data exist on the impact of postprocedural routine inflammatory parameters (pRIP) on TAVR outcomes.

Purpose of the Study:

• To investigate the incidence and clinical significance of pRIP after transapical (TA) and transfemoral (TF)-TAVR.
• To identify predictors of mortality in TAVR patients based on inflammatory markers and risk scores.

Main Methods:

• Retrospective analysis of 81 high-risk TAVR patients (2017-2018).
• Comparison of pRIP (pCRP, pL) and postprocedural fever between TA-TAVR and TF-TAVR groups.
• Assessment of outcomes using Valve Academic Research Consortium (VARC-2) criteria.
• Survival analysis using hazard ratios (HR) and confidence intervals (CI) for pRIP and logistic EuroSCORE I (ES).

Main Results:

• TA-TAVR patients showed significantly higher postprocedural C-reactive protein (pCRP) and leucocytes (pL) compared to TF-TAVR.
• No significant difference in postprocedural fever incidence, but a trend towards longer fever duration in TA-TAVR.
• pCRP >30 mg/dl (HR 3.15), logistic ES >20% (HR 2.95), and pL >14/nl (HR 2.44) were associated with mortality.
• Multivariate analysis revealed a significant association between pCRP >30 mg/dl and ES >20% (p < 0.001).

Conclusions:

• Postprocedural routine inflammatory parameters are significantly increased in TA-TAVR patients.
• Elevated pCRP, ES, and pL indicate an adverse prognosis and warrant further investigation.
• These inflammatory markers and risk scores are crucial for predicting mortality in TAVR patients.