Prognostic value of nutritional and inflammatory scores in Transcatheter aortic valve replacement patients

Öz

Background: Aortic Stenosis (AS) is a common heart valve disease that especially affects the elderly population and is seen with the aging of the society. In recent years Transcatheter aortic valve replacement patients (TAVR) has been increasingly applied worldwide as a procedure for the treatment of severe AS. Recently, various biomarkers and derived marker approaches have been studied in AS patient groups as in many cardiovascular diseases. Since it has been previously shown that increased inflammatory scores and poor nutritional scores are closely associated with the development process and prognosis of cardiovascular diseases, we hypothesized that these scores may be associated with prognosis after TAVR. Therefore, in this study, we aimed to make a detailed evaluation in terms of mortality determinants after TAVR. Methods and Results: 118 TAVR patients were included in the analysis. Median follow-up of 118 patients was 40.5 months. In terms of inflammatory status scores, the systemic immune inflammatory (SII) score (p= 0.027), the neutrophil/lymphocyte ratio (NLR) score (p= 0.012), and the platelet/lymphocyte ratio (PLR) score (p= 0.012) in the death group was found to be significantly higher. As nutritional status scores, the prognostic nutritional index (PNI) score (p= 0.003) was lower in the death group and the median Controlling Nutritional Status (CONUT) score (p= 0.002)) found significantly higher. Conclusion: In severe and high-risk AS patients undergoing TAVR, measurement of malnutrition with the CONUT score and increased inflammatory status with the SII score was associated with an increased risk of all causes mortality in long-term follow-up. It has been determined that the development of complications related to the procedure is an indicator of increased mortality not only in the short term but also in the long-term follow-up.

Anahtar Kelimeler

• CONUT
• SII
• TAVI - PNI - NLR

Kaynakça

1. 1.Lindman BR, Clavel MA, Mathieu P, et al. Calcificaortic stenosis. Nat Rev Dis Primers. 2016 Mar3;2:16006.
2. 2.Otto CM, Prendergast B. Aortic valve stenosis from patients at risk to severe valve obstruction. NewEngl J Med2014;371:744–56.
3. 3.Dvir D, Barbash IM, Ben-Dor I, et al. Thedevelopment of transcatheter aortic valvereplacement in the USA. Arch Cardiovasc Dis2012;105:160–4.
4. 4.Arora S, Strassle PD, Kolte D, et al. Length of stayand discharge disposition after transcatheter versussurgical aortic valve replacement in the UnitedStates. Circ Cardiovasc Interv 2018;11:e006929.
5. 5. Heitzer T, Schlinzig T, Krohn K, Meinertz T, MünzelT.Endothelial dysfunction, oxidative stress, and riskof cardiovascular events in patients with coronaryartery disease. Circulation. 2001;104:2673–8.