Association between haematological parameters and outcomes following transcatheter aortic valve implantation at mid-term follow-up
Background Patients undergoing transcatheter aortic valve implantation (TAVI) often have multiple comorbidities, such as anaemia and chronic inflammatory disorders. We sought to investigate the association between preoperative and postoperative haematological parameters and clinical outcomes in TAVI...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-12-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/9/2/e002108.full |
| _version_ | 1811296665019088896 |
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| author | Serge C Harb Amar Krishnaswamy Samir Kapadia Anas Saad Rishi Puri Essa Hariri Omar Abdelfattah James Yun Grant W Reed Abdelrahman Abushouk Ankit Agrawal Iryna Dykun Tikal Kansara Osamah Badwan Connor Jaggi Medhat Farwati |
| author_facet | Serge C Harb Amar Krishnaswamy Samir Kapadia Anas Saad Rishi Puri Essa Hariri Omar Abdelfattah James Yun Grant W Reed Abdelrahman Abushouk Ankit Agrawal Iryna Dykun Tikal Kansara Osamah Badwan Connor Jaggi Medhat Farwati |
| author_sort | Serge C Harb |
| collection | DOAJ |
| description | Background Patients undergoing transcatheter aortic valve implantation (TAVI) often have multiple comorbidities, such as anaemia and chronic inflammatory disorders. We sought to investigate the association between preoperative and postoperative haematological parameters and clinical outcomes in TAVI patients at mid-term follow-up.Methods In the present study, consecutive patients (N=908) who underwent TAVI at the Cleveland Clinic between 2017 and 2019 with available complete blood counts were studied. Data were collected on preoperative and postoperative anaemia and elevations in neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Survival analysis was used to study the association of haematologic parameters with all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE).Results We found that preoperative anaemia and elevated NLR were significantly associated with a higher risk of all-cause mortality (aHR=1.6 (95% CI: 1.1 to 2.0) and 1.4 (95% CI: 1.1 to 1.6), respectively) and MACCE (aHR=1.9 (95% CI: 1.3 to 2.8) and 1.6 (95% CI: 1.1 to 2.4), respectively). While an elevated preoperative PLR was not associated with increased mortality risk, it had a significant association with MACCE risk (aHR: 1.6 (95% CI: 1.1 to 2.4)). Further, postoperative anaemia, elevated NLR and PLR were associated with increased risks of all-cause mortality and MACCE.Conclusion Pathological alterations in haematological parameters were associated with higher risks of post-TAVI mortality and MACCE at mid-term follow-up. Our findings advocate for further incorporating haematological parameters in the preoperative evaluation of TAVI candidates. |
| first_indexed | 2024-04-13T05:52:49Z |
| format | Article |
| id | doaj.art-0ba6cc72369c47a7b40631aea9bfe1aa |
| institution | Directory Open Access Journal |
| issn | 2053-3624 |
| language | English |
| last_indexed | 2024-04-13T05:52:49Z |
| publishDate | 2022-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj.art-0ba6cc72369c47a7b40631aea9bfe1aa2022-12-22T02:59:43ZengBMJ Publishing GroupOpen Heart2053-36242022-12-019210.1136/openhrt-2022-002108Association between haematological parameters and outcomes following transcatheter aortic valve implantation at mid-term follow-upSerge C Harb0Amar Krishnaswamy1Samir Kapadia2Anas Saad3Rishi Puri4Essa Hariri5Omar Abdelfattah6James Yun7Grant W Reed8Abdelrahman Abushouk9Ankit Agrawal10Iryna Dykun11Tikal Kansara12Osamah Badwan13Connor Jaggi14Medhat Farwati152 Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA2 Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, United StatesDepartment of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA3 Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USAHeart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USADepartment of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USADepartment of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USAHeart, Vascular & Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USAHeart, Vascular & Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USADepartment of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USADepartment of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USADepartment of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USADepartment of Internal Medicine, Cleveland Clinic Union Hospital, Dover, Ohio, USADepartment of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USADepartment of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USADepartment of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USABackground Patients undergoing transcatheter aortic valve implantation (TAVI) often have multiple comorbidities, such as anaemia and chronic inflammatory disorders. We sought to investigate the association between preoperative and postoperative haematological parameters and clinical outcomes in TAVI patients at mid-term follow-up.Methods In the present study, consecutive patients (N=908) who underwent TAVI at the Cleveland Clinic between 2017 and 2019 with available complete blood counts were studied. Data were collected on preoperative and postoperative anaemia and elevations in neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Survival analysis was used to study the association of haematologic parameters with all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE).Results We found that preoperative anaemia and elevated NLR were significantly associated with a higher risk of all-cause mortality (aHR=1.6 (95% CI: 1.1 to 2.0) and 1.4 (95% CI: 1.1 to 1.6), respectively) and MACCE (aHR=1.9 (95% CI: 1.3 to 2.8) and 1.6 (95% CI: 1.1 to 2.4), respectively). While an elevated preoperative PLR was not associated with increased mortality risk, it had a significant association with MACCE risk (aHR: 1.6 (95% CI: 1.1 to 2.4)). Further, postoperative anaemia, elevated NLR and PLR were associated with increased risks of all-cause mortality and MACCE.Conclusion Pathological alterations in haematological parameters were associated with higher risks of post-TAVI mortality and MACCE at mid-term follow-up. Our findings advocate for further incorporating haematological parameters in the preoperative evaluation of TAVI candidates.https://openheart.bmj.com/content/9/2/e002108.full |
| spellingShingle | Serge C Harb Amar Krishnaswamy Samir Kapadia Anas Saad Rishi Puri Essa Hariri Omar Abdelfattah James Yun Grant W Reed Abdelrahman Abushouk Ankit Agrawal Iryna Dykun Tikal Kansara Osamah Badwan Connor Jaggi Medhat Farwati Association between haematological parameters and outcomes following transcatheter aortic valve implantation at mid-term follow-up Open Heart |
| title | Association between haematological parameters and outcomes following transcatheter aortic valve implantation at mid-term follow-up |
| title_full | Association between haematological parameters and outcomes following transcatheter aortic valve implantation at mid-term follow-up |
| title_fullStr | Association between haematological parameters and outcomes following transcatheter aortic valve implantation at mid-term follow-up |
| title_full_unstemmed | Association between haematological parameters and outcomes following transcatheter aortic valve implantation at mid-term follow-up |
| title_short | Association between haematological parameters and outcomes following transcatheter aortic valve implantation at mid-term follow-up |
| title_sort | association between haematological parameters and outcomes following transcatheter aortic valve implantation at mid term follow up |
| url | https://openheart.bmj.com/content/9/2/e002108.full |
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