C-Reactive Protein to Albumin Ratio in Patients Undergoing Transcatheter Aortic Valve Replacement |
| |
| Affiliation: | 1. Department of Internal Medicine III, Cardiology and Angiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany;2. Department of Cardiac and Vascular Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany;3. Department of Medicine II, Heart Center Bonn, University Hospital Bonn, Bonn, Germany;4. Department of General and Interventional Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany;5. Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany;6. Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany;7. DZHK (German Centre for Cardiovascular Research), partner site Hamburg, Kiel, Lübeck, Germany;1. Division of Cardiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul;2. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul;3. Division of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea;1. Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Jacksonville, FL;2. Resident in Gastroenterology and Hepatology, Mayo Clinic School of Graduate Medical Education, Jacksonville, FL;3. Advisor to residents and Consultant in Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL;1. Department of Neurology, Mayo Clinic, Rochester, MN;2. Department of Radiology, Mayo Clinic, Rochester, MN;1. Department of Neurology, Mayo Clinic, Rochester, MN, USA;2. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA;3. Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA;4. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA;5. Department of Radiology, Mayo Clinic, Rochester, MN, USA;6. Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA |
| |
| Abstract: | ObjectiveTo evaluate whether the serum C-reactive protein to albumin ratio (CAR) could be used for risk stratification of patients undergoing transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS).Patients and MethodsFrailty is a predictor of poor outcomes in patients undergoing AS interventions. The CAR reflects key components of frailty (systemic inflammation and nutrition) and could potentially be implemented into assessment and management strategies for patients with AS. From March 1, 2010, through February 29, 2020, 1836 patients were prospectively enrolled in an observational TAVR database. Patients (prospective development cohort, n=763) were grouped into CAR quartiles to compare the upper quartile (CAR Q4) with the lower quartiles (CAR Q1-3). Primary end point was all-cause mortality. Results were verified in an independent retrospective cohort (n=1403).ResultsThe CAR Q4 had a higher prevalence of impaired left ventricular function, atrial fibrillation, diabetes, and cerebrovascular disease and a higher median logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) vs CAR Q1-3. After median follow-up of 15.0 months, all-cause mortality was significantly higher in CAR Q4 vs CAR Q1-3 (P<.001). In multivariable analyses, risk factors for all-cause mortality were CAR Q4 (>0.1632; hazard ratio, 1.45; 95% confidence interval, 1.05 to 2.00; P=.03), N-terminal pro–B-type natriuretic peptide Q4 (>3230 pg/mL [to convert to ng/L, multiply by 1), high-sensitivity troponin T Q4 (>0.0395 ng/mL [to convert to μg/L, multiply by 1]), above-median logistic EuroSCORE (16.1%), myocardial infarction, Acute Kidney Injury Network stage 3, and life-threatening bleeding.ConclusionElevated CAR was associated with increased risk of all-cause mortality in patients undergoing transfemoral TAVR. The CAR, a simple, objective tool to assess frailty, could be incorporated into assessing patients with AS being considered for TAVR. |
| |
| Keywords: | AF" },{" #name" :" keyword" ," $" :{" id" :" kwrd0015" }," $$" :[{" #name" :" text" ," _" :" atrial fibrillation AKIN" },{" #name" :" keyword" ," $" :{" id" :" kwrd0025" }," $$" :[{" #name" :" text" ," _" :" Acute Kidney Injury Network AR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0035" }," $$" :[{" #name" :" text" ," _" :" aortic regurgitation AS" },{" #name" :" keyword" ," $" :{" id" :" kwrd0045" }," $$" :[{" #name" :" text" ," _" :" aortic stenosis AVA" },{" #name" :" keyword" ," $" :{" id" :" kwrd0055" }," $$" :[{" #name" :" text" ," _" :" aortic valve area BMI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0065" }," $$" :[{" #name" :" text" ," _" :" body mass index CAD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0075" }," $$" :[{" #name" :" text" ," _" :" coronary artery disease CAR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0085" }," $$" :[{" #name" :" text" ," _" :" C-reactive protein to albumin ratio CI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0095" }," $$" :[{" #name" :" text" ," _" :" confidence interval COPD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0105" }," $$" :[{" #name" :" text" ," _" :" chronic obstructive pulmonary disease CRP" },{" #name" :" keyword" ," $" :{" id" :" kwrd0115" }," $$" :[{" #name" :" text" ," _" :" C-reactive protein CVD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0125" }," $$" :[{" #name" :" text" ," _" :" cerebrovascular disease EuroSCORE" },{" #name" :" keyword" ," $" :{" id" :" kwrd0135" }," $$" :[{" #name" :" text" ," _" :" European System for Cardiac Operative Risk Evaluation GFR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0145" }," $$" :[{" #name" :" text" ," _" :" glomerular filtration rate HR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0155" }," $$" :[{" #name" :" text" ," _" :" hazard ratio hs-TnT" },{" #name" :" keyword" ," $" :{" id" :" kwrd0165" }," $$" :[{" #name" :" text" ," _" :" high-sensitivity troponin T IQR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0175" }," $$" :[{" #name" :" text" ," _" :" interquartile range LV" },{" #name" :" keyword" ," $" :{" id" :" kwrd0185" }," $$" :[{" #name" :" text" ," _" :" left ventricular LVEF" },{" #name" :" keyword" ," $" :{" id" :" kwrd0195" }," $$" :[{" #name" :" text" ," _" :" left ventricular ejection fraction MPG" },{" #name" :" keyword" ," $" :{" id" :" kwrd0205" }," $$" :[{" #name" :" text" ," _" :" mean pressure gradient MR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0215" }," $$" :[{" #name" :" text" ," _" :" mitral regurgitation NT-proBNP" },{" #name" :" keyword" ," $" :{" id" :" kwrd0225" }," $$" :[{" #name" :" text" ," _" :" N-terminal pro–B-type natriuretic peptide PAD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0235" }," $$" :[{" #name" :" text" ," _" :" peripheral artery disease PAH" },{" #name" :" keyword" ," $" :{" id" :" kwrd0245" }," $$" :[{" #name" :" text" ," _" :" pulmonary arterial hypertension Q" },{" #name" :" keyword" ," $" :{" id" :" kwrd0255" }," $$" :[{" #name" :" text" ," _" :" quartile ROC" },{" #name" :" keyword" ," $" :{" id" :" kwrd0265" }," $$" :[{" #name" :" text" ," _" :" receiver operating characteristic STS" },{" #name" :" keyword" ," $" :{" id" :" kwrd0275" }," $$" :[{" #name" :" text" ," _" :" Society of Thoracic Surgeons TAVR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0285" }," $$" :[{" #name" :" text" ," _" :" transcatheter aortic valve replacement TF" },{" #name" :" keyword" ," $" :{" id" :" kwrd0295" }," $$" :[{" #name" :" text" ," _" :" transfemoral TR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0305" }," $$" :[{" #name" :" text" ," _" :" tricuspid regurgitation VARC-2" },{" #name" :" keyword" ," $" :{" id" :" kwrd0315" }," $$" :[{" #name" :" text" ," _" :" Valve Academic Research Consortium-2 WBC" },{" #name" :" keyword" ," $" :{" id" :" kwrd0325" }," $$" :[{" #name" :" text" ," _" :" white blood cell |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
