C-Reactive Protein to Albumin Ratio in Patients Undergoing Transcatheter Aortic Valve Replacement
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C-Reactive Protein to Albumin Ratio in Patients Undergoing Transcatheter Aortic Valve Replacement. / Seoudy, Hatim; Shamekhi, Jasmin; Voigtländer, Lisa; Ludwig, Sebastian; Frank, Johanne; Kujat, Tim; Bramlage, Peter; Al-Kassou, Baravan; Sugiura, Atsushi; Rangrez, Ashraf Yusuf; Schofer, Niklas; Puehler, Thomas; Lutter, Georg; Seiffert, Moritz; Nickenig, Georg; Conradi, Lenard; Frey, Norbert; Westermann, Dirk; Sinning, Jan-Malte; Frank, Derk.
In: MAYO CLIN PROC, Vol. 97, No. 5, 05.2022, p. 931-940.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - C-Reactive Protein to Albumin Ratio in Patients Undergoing Transcatheter Aortic Valve Replacement
AU - Seoudy, Hatim
AU - Shamekhi, Jasmin
AU - Voigtländer, Lisa
AU - Ludwig, Sebastian
AU - Frank, Johanne
AU - Kujat, Tim
AU - Bramlage, Peter
AU - Al-Kassou, Baravan
AU - Sugiura, Atsushi
AU - Rangrez, Ashraf Yusuf
AU - Schofer, Niklas
AU - Puehler, Thomas
AU - Lutter, Georg
AU - Seiffert, Moritz
AU - Nickenig, Georg
AU - Conradi, Lenard
AU - Frey, Norbert
AU - Westermann, Dirk
AU - Sinning, Jan-Malte
AU - Frank, Derk
N1 - Copyright © 2021. Published by Elsevier Inc.
PY - 2022/5
Y1 - 2022/5
N2 - OBJECTIVE: To 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 METHODS: Frailty 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).RESULTS: The 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.CONCLUSION: Elevated 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.
AB - OBJECTIVE: To 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 METHODS: Frailty 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).RESULTS: The 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.CONCLUSION: Elevated 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.
KW - Aortic Valve/surgery
KW - Aortic Valve Stenosis
KW - C-Reactive Protein
KW - Frailty
KW - Humans
KW - Prospective Studies
KW - Retrospective Studies
KW - Risk Factors
KW - Transcatheter Aortic Valve Replacement/adverse effects
KW - Treatment Outcome
U2 - 10.1016/j.mayocp.2021.11.022
DO - 10.1016/j.mayocp.2021.11.022
M3 - SCORING: Journal article
C2 - 35410750
VL - 97
SP - 931
EP - 940
JO - MAYO CLIN PROC
JF - MAYO CLIN PROC
SN - 0025-6196
IS - 5
ER -
