{"title":"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","authors":"Hani AziziKia , Asma Mousavi , Shayan Shojaei , Farhad Shaker , Dorsa Salabat , Razman Arabzadeh Bahri , Reza Hosseini Dolama , Hanieh Radkhah MD","doi":"10.1016/j.hrtlng.2024.10.011","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>These findings highlight the importance of inflammatory and cardiac biomarkers in risk stratification and patient management in TAVI procedures.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Pages 229-240"},"PeriodicalIF":2.4000,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predictive potential of pre-procedural cardiac and inflammatory biomarkers regarding mortality following transcatheter aortic valve implantation: A systematic review and meta-analysis\",\"authors\":\"Hani AziziKia , Asma Mousavi , Shayan Shojaei , Farhad Shaker , Dorsa Salabat , Razman Arabzadeh Bahri , Reza Hosseini Dolama , Hanieh Radkhah MD\",\"doi\":\"10.1016/j.hrtlng.2024.10.011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>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.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>These findings highlight the importance of inflammatory and cardiac biomarkers in risk stratification and patient management in TAVI procedures.</div></div>\",\"PeriodicalId\":55064,\"journal\":{\"name\":\"Heart & Lung\",\"volume\":\"69 \",\"pages\":\"Pages 229-240\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-11-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Heart & Lung\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0147956324001997\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart & Lung","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0147956324001997","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Predictive potential of pre-procedural cardiac and inflammatory biomarkers regarding mortality following transcatheter aortic valve implantation: A systematic review and meta-analysis
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.
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.
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