Preprocedural ALBI score predicts short- and long-term mortality after TAVI: a single-center cohort

To evaluate the prognostic significance of the preprocedural albumin - bilirubin (ALBI) score on short- and long-term outcomes after transcatheter aortic valve implantation (TAVI).

We retrospectively analyzed 737 consecutive patients who underwent TAVI. Patients were stratified into tertiles according to ALBI score. Baseline clinical, echocardiographic, laboratory features were compared across tertiles. The primary endpoint was long-term all-cause mortality; secondary endpoints included in-hospital mortality and major complications. Kaplan-Meier analysis assessed survival, and Cox-regression models evaluated predictors of long-term mortality after adjustment for conventional risk factors.

Higher ALBI tertiles were associated with a greater comorbidity burden, worse ventricular function, and elevated biomarkers of inflammation and cardiac stress. In-hospital mortality increased across tertiles (5.3%, 7.3%, 11.8%). Long-term mortality also rose progressively (7.3%, 9.8%, 11.8%), with 60-month survival rates of approximately 90% (T1), 88% (T2), and 73% (T3). ALBI score independently predicted long-term mortality (HR 1.86, 95% CI 1.23-2.82), along with chronic kidney disease and lower TAPSE. Restricted cubic spline analysis demonstrated a near-linear association between ALBI and mortality risk.

Preprocedural ALBI score is independently associated with both short and long-term mortality after TAVI and may reflect systemic vulnerability not captured by conventional risk models. Incorporating ALBI into preprocedural assessment could enhance risk stratification.