Preoperative Outcome Predictors in Aortic Valve Replacement: A Single-Center Retrospective Study

Area of Science:

• Cardiology
• Biomarkers
• Surgical Outcomes

Background:

• Major adverse complications (MACs) are critical concerns following cardiac surgery.
• Predictive biomarkers are essential for stratifying patient risk after surgical aorta valve replacement (SAVR).

Purpose of the Study:

• To investigate the predictive value of the blood urea nitrogen (BUN) to serum albumin ratio (BAR) and the inflammatory prognostic index (IPI) for MACs post-SAVR.
• To assess the combined effect of BAR and IPI with left atrium volume (LAV) on MACs.

Main Methods:

• Retrospective analysis of clinical, echocardiographic, and laboratory data from 195 patients undergoing SAVR.
• Logistic regression models were used to identify independent predictors of MACs, including BAR, IPI, and LAV.
• MACs included death, re-exploration, myocardial infarction, and cerebral ischemia.

Main Results:

• The blood urea nitrogen to serum albumin ratio (BAR) and inflammatory prognostic index (IPI) were independently associated with MACs after SAVR.
• Elevated left atrium volume (LAV) combined with higher BAR or IPI significantly increased the risk of MACs.
• Higher LAV and BAR increased MAC risk by 9.8-fold; higher LAV and IPI increased risk by 4.5-fold.

Conclusions:

• BAR and IPI are valuable, easily accessible pre-operative biomarkers for predicting MACs following SAVR.
• The combination of elevated LAV with BAR or IPI provides enhanced risk stratification for adverse outcomes.
• Routine assessment of these biomarkers can aid in optimizing patient management and predicting surgical risk.