The Triglycerides, total Cholesterol, and Body weight Index associating with frailty and predicting poor outcome after transcatheter aortic valve implantation: insights from LAPLACE-TAVI registry.

Abstract

Aims: The nutritional status and frailty are crucial in patients with aortic stenosis undergoing transcatheter aortic valve implantation (TAVI), as they significantly impact outcomes. We have previously developed an easily calculable nutritional index, TCBI (Triglycerides, total Cholesterol, and Body weight Index), which has been validated as a prognostic indicator in various cardiovascular disease contexts. This study aimed to evaluate the impact of a low TCBI on the frailty and outcomes of patients undergoing TAVI.

Methods and results: This study is a part of a Japanese multi-centre prospective registry database of TAVI cases (n = 824). Participants were categorized into three groups based on TCBI tertiles before TAVI. The primary endpoint was all-cause mortality with a follow-up duration of up to 3 years. In the lowest TCBI tertile group, motor functions reflecting frailty were substantially impaired, and cumulative incidences of primary endpoint was significantly higher compared to other groups. Multivariate Cox proportional hazard analyses adjusted by risk factors for poor outcomes following TAVI identified low TCBI significantly associated with an increased risk of the primary endpoint [hazard ratio (HR) and 95% confidence interval (95% CI) of 1 SD lower TCBI for all-cause mortality: 1.52, 1.08-2.13, P = 0.015]. Moreover, in individuals who experienced serious preprocedural complications, the negative prognostic impact of low TCBI was significantly amplified (HR and 95% CI: 4.9, 1.9-12.5, P < 0.001).

Conclusion: The present findings underscore the importance of nutritional assessment in patients undergoing TAVI. TCBI proved useful for accurate risk stratification and determining TAVI procedural strategies.