Predictive potential of pre-procedural cardiac and inflammatory biomarkers regarding mortality following transcatheter aortic valve implantation: A systematic review and meta-analysis

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Heart & Lung Pub Date : 2024-11-06 DOI:10.1016/j.hrtlng.2024.10.011

Hani AziziKia , Asma Mousavi , Shayan Shojaei , Farhad Shaker , Dorsa Salabat , Razman Arabzadeh Bahri , Reza Hosseini Dolama , Hanieh Radkhah MD

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Abstract

Background

Aortic stenosis (AS) is a common heart valve disease, especially in aging populations. While surgical aortic valve replacement (SAVR) is the standard treatment, many patients are ineligible. Transcatheter aortic valve implantation (TAVI) offers an alternative, especially for high-risk patients, but is not without complications. Identifying biomarkers that predict post-TAVI mortality is essential for optimizing outcomes.

Objectives

The purpose of this systematic review and meta-analysis is to evaluate the role of cardiac and inflammatory biomarkers in predicting short-term and mid to long-term mortality following TAVI.

Methods

We searched PubMed, Scopus, Embase, and Web of Science for studies examining the impact of inflammatory and cardiac biomarkers on mortality following TAVI. Mean differences (MDs) and 95 % confidence interval (CI) were calculated using a random-effect model.

Results

Twenty-eight studies involving 10,560 patients were included, with 1867 in the mortality group. Mortality was significantly associated with higher pre-procedural levels of creatinine (0.41; 95 % CI: [0.35, 0.48]), brain natriuretic peptide (0.58; 95 % CI: [0.43, 0.73]), C-reactive protein (0.55; 95 % CI: [0.45, 0.64]), and white blood cell count (0.18; 95 % CI: [0.06, 0.31]), and lower pre-procedural levels of hemoglobin (−0.49; 95 % CI: [−0.60, −0.38]) and albumin (−0.18; 95 % CI: [−0.24, −0.13]). These associations remained statistically significant in subgroup analyses for both mid to long-term mortality and short-term mortality, except for WBC levels, which were not significantly associated with short-term mortality, and Hb, for which short-term data were insufficient. Platelet count showed no significant difference.

Conclusion

These findings highlight the importance of inflammatory and cardiac biomarkers in risk stratification and patient management in TAVI procedures.

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经导管主动脉瓣植入术后死亡率的术前心脏和炎症生物标志物的预测潜力：系统回顾和荟萃分析

背景主动脉瓣狭窄（AS）是一种常见的心脏瓣膜疾病，尤其是在老年人群中。虽然手术主动脉瓣置换术（SAVR）是标准治疗方法，但许多患者不符合条件。经导管主动脉瓣植入术（TAVI）提供了另一种选择，尤其适用于高危患者，但并非没有并发症。本系统综述和荟萃分析旨在评估心脏和炎症生物标志物在预测 TAVI 术后短期和中长期死亡率方面的作用。方法我们检索了 PubMed、Scopus、Embase 和 Web of Science，以查找有关炎症和心脏生物标志物对 TAVI 术后死亡率影响的研究。结果共纳入了208项研究，涉及10560名患者，其中死亡率组有1867人。死亡率与手术前肌酐（0.41；95 % CI：[0.35，0.48]）、脑钠肽（0.58；95 % CI：[0.43，0.73]）、C 反应蛋白（0.55；95 % CI：[0.45，0.64]）和白细胞计数（0.18；95 % CI：[0.06，0.31]），以及较低的术前血红蛋白水平（-0.49；95 % CI：[-0.60，-0.38]）和白蛋白水平（-0.18；95 % CI：[-0.24，-0.13]）。在中长期死亡率和短期死亡率的亚组分析中，这些相关性仍具有统计学意义，但白细胞水平和血红蛋白除外，前者与短期死亡率无显著相关性，后者的短期数据不足。结论这些研究结果突显了炎症和心脏生物标志物在 TAVI 手术风险分层和患者管理中的重要性。

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来源期刊

Heart & Lung 医学-呼吸系统

CiteScore

4.60

自引率

3.60%

发文量

184

审稿时长

35 days

期刊介绍： Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders. The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.