The Relationship Between Acute Renal Failure After Transcatheter Aortic Valve Replacement And Preprocedural Neutrophil To Lymphocyte Ratio

Year 2020, Volume: 47 Issue: 1, 1 - 9, 17.03.2020

Nizamettin Selçuk Yelgeç Mehmet Baran Karataş Can Yücel Karabay Yiğit Çanga Ali Nazmi Çalık Barış Şimşek Özge Güzelburç Ayşe Emre

https://doi.org/10.5798/dicletip.705532

Abstract

Objective: Transcatheter aortic valve replacement (TAVR) is a less invasive alternative to open-heart surgery for patients with severe symptomatic aortic stenosis who has a high risk for surgery. Acute kidney injury (AKI) is not a rare complication after TAVR and has been associated with poorer outcomes and survival. This study aims to analyze the relation between serum Neutrophil-lymphocyte ratio (NLR) and AKI in Post-TAVR patients.
Methods: 148 patients who have been performed TAVR at our institution between 2010 and 2018, analyzed retrospectively. We divided the patients into two groups. Group 1 (n=116): The patients who did not develop AKI after TAVR procedure (control group) and Group 2 (n=32): The patients who developed AKI after TAVR. The independent relation between possible independent predictors of AKI in post-TAVI patients was analyzed by regression analysis.
Results: 32 patients (22%) suffered from AKI after TAVR during hospitalization. NLR was significantly associated with the development of AKI (3.22 ±0.62 vs. 2.42 ± 0.45, p<0.01). In multivariate regression analysis, NLR (OR: 1.79, p=0,01), diabetes mellitus (OR: 1.41, p=0,01), and preprocedural creatinine levels (OR: 1.86, p=0,01) were found to be independently correlated with the development of AKI after TAVR.
Conclusion: This study suggests that High NLR was independently associated with AKI in post-TAVR patients. High values of NLR may indicate a poor prognosis.

Keywords

Neutrophil to lymphocyte ratio, Transcatheter aortic valve implantation

References

• 1. Lindman BR, Clavel M-A, Mathieu P, et al. Calcific aortic stenosis. Nat Rev Dis Prim. 2016; 2: 16006.
• 2. Eveborn GW, Schirmer H, Heggelund G, et al. The evolving epidemiology of valvular aortic stenosis. theTromsø Study. Heart. 2013 Mar 15; 99: 396–400.
• 3. Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am CollCardiol. 2014 Jun 10; 63: e57-185.
• 4. Bagur R, Webb JG, Nietlispach F, et al. Acute kidney injury following transcatheter aortic valve implantation: predictive factors, prognostic value, and comparison with surgical aortic valve replacement. Eur Heart J. 2010 Apr 1; 31: 865–74.
• 5. Najjar M, Salna M, George I. Acute kidney injury after aortic valve replacement: Incidence, risk factors and outcomes. Expert Review of Cardiovascular Therapy. 2015.
• 6. Papa A, Emdin M, Passino C, et al. Predictive value of elevated neutrophil-lymphocyte ratio on cardiac mortality in patients with stable coronary artery disease. ClinChimActa. 2008 Sep; 395: 27–31.
• 7. Park B-J, Shim J-Y, Lee H-R, et al. Relationship of neutrophil-lymphocyte ratio with arterial stiffness and coronary calcium score. ClinChimActa. 2011 May 12; 412: 925–9.
• 8. Zazula AD, Précoma-Neto D, Gomes AM, et al. An assessment of neutrophils/lymphocytes ratio in patients suspected of acute coronary syndrome. Arq Bras Cardiol. 2008 Jan; 90: 31–6.
• 9. Duffy BK, Gurm HS, Rajagopal V, et al. Usefulness of an Elevated Neutrophil to Lymphocyte Ratio in Predicting Long-Term Mortality After Percutaneous Coronary Intervention. Am J Cardiol. 2006 Apr 1; 97: 993–6.
• 10. Gibson PH, Cuthbertson BH, Croal BL, et al. Usefulness of Neutrophil/Lymphocyte Ratio As Predictor of New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting. Am J Cardiol. 2010 Jan 15; 105: 186–91.
• 11. Rudiger A, Burckhardt OA, Harpes P, et al. The relative lymphocyte count on hospital admission is a risk factor for long-term mortality in patients with acute heart failure. Am J Emerg Med. 2006 Jul; 24: 451–4.
• 12. Gibson PH, Croal BL, Cuthbertson BH, et al. Preoperative neutrophil-lymphocyte ratio and outcome from coronary artery bypass grafting. Am Heart J. 2007 Nov; 154: 995–1002.
• 13. Bhat T, Teli S, Rijal J, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert Rev CardiovascTher. 2013 Jan 10; 11: 55–9.
• 14. Kappetein AP, Head SJ, Généreux P, et al. Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document†. Eur Heart J. 2012 Oct; 33: 2403–18.
• 15. Roques F, Michel P, Goldstone AR, et al. The logistic EuroSCORE. Eur Heart J. 2003 May 1; 24: 882–3.
• 16. Park JJ, Jang HJ, Oh IY, et al. Prognostic value of neutrophil to lymphocyte ratio in patients presenting with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Am J Cardiol. 2013;
• 17. Bhat T, Teli S, Rijal J, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: A review. Expert Review of Cardiovascular Therapy. 2013.
• 18. Onuk T, Güngör B, Karataş B, et al. Increased neutrophil to lymphocyte ratio is associated with in-hospital mortality in patients with aortic dissection. Clin Lab. 2015; 61.
• 19. Yin Y, Wang J, Wang X, et al. Prognostic value of the neutrophil to lymphocyte ratio in lung cancer: A meta-analysis. Clinics. 2015;
• 20. Turkmen K, Guney I, Yerlikaya FH, et al. The relationship between neutrophil-to-lymphocyte ratio and inflammation in end-stage renal disease patients. Ren Fail. 2012; 34: 155–9.
• 21. Erdem E. Neutrophil lymphocyte ratio in aute renal failure. Indian J Nephrol. 2015; 25: 126–7.
• 22. Mozos I, Malainer C, Horbańczuk J, et al. Inflammatory Markers for Arterial Stiffness in Cardiovascular Diseases. Front Immunol. 2017 Aug 31; 8: 1058.
• 23. Li J, Chen Q, Luo X, et al. Neutrophil-to-Lymphocyte Ratio Positively Correlates to Age in Healthy Population. J Clin Lab Anal. 2015 Nov; 29: 437–43.
• 24. Nam S-H, Kang S-G, Song S-W. The Neutrophil-Lymphocyte Ratio Is Associated with Coronary Artery Calcification in Asymptomatic Korean Males: A Cross-Sectional Study. Biomed Res Int. 2017 Feb 9; 2017: 1–8.
• 25. Candela P, Evola S, Lunetta M, et al. The spectrum of risk factors for contrast induced nephropathy in patients undergoing coronary angiography or intervention. J Indian CollCardiol. 2014 Sep 1; 4: 157–61.
• 26. Gürsoy OM, Karakoyun S, Kalçık M, et al. Usefulness of Novel Hematologic Inflammatory Parameters to Predict Prosthetic Mitral Valve Thrombosis. Am J Cardiol. 2014 Mar; 113: 860–4.
• 27. Ram P, Mezue K, Pressman G, et al. Acute kidney injury post-transcatheter aortic valve replacement. ClinCardiol. 2017 Dec 1; 40: 1357–62.