Arq. Bras. Cardiol. 2021; 117(5): 1018-1027
C-reactive Protein as a Prognostic Marker of 1-Year Mortality after Transcatheter Aortic Valve Implantation in Aortic Stenosis
André Luiz Silveira Sousa
, Luiz Antônio Ferreira Carvalho, Constantino González Salgado, Rafael Lauria de Oliveira, Luciana Cristina Correia Lima e Lima, Nelson Durval Ferreira Gomes de Mattos, Francisco Eduardo Sampaio Fagundes, Alexandre Siciliano Colafranceschi
, Evandro Tinoco Mesquita
This Original Article is referred by the Short Editorial "The Role of Inflammation in Post-TAVI Outcomes".
Abstract
Background:
C-reactive protein (CRP) is an inflammation biomarker that can be a predictor of adverse events in cardiovascular procedures. Its use in the assessment of long-term prognosis of transcatheter aortic valve implantation (TAVI) is still incipient.
Objective:
To evaluate CRP as a prognostic marker in the first year after TAVI in aortic stenosis (AoS).
Methods:
CRP was assessed on the first postoperative week in a retrospective cohort of patients with AoS. Pre- and post- CRP levels were correlated with mortality, and predictors of 1-year mortality were investigated. Multivariate Cox regression was performed to identify independent factors of 1-year mortality.
Results:
This study evaluated 130 patients who underwent TAVI, with median age of 83 years, and 49% of women. High pre-TAVI CRP (> 0.5 mg/dL) was observed in 34.5% of the cases. Peak CRP was 7.0 (5.3-12.1) mg/dL no quarto dia. The rate of 1-year mortality was 14.5% (n = 19), being greater in the groups with high pre-TAVI CRP (68.8% vs 29.1%; p = 0,004) and with peak CRP ≥ 10.0 mg/dL (64.7% vs 30.8%; p = 0,009). Independent predictors of mortality were acute renal failure (ARF) (hazard ratio [HR] = 7.43; 95% confidence interval [95%CI], 2.1-24.7; p = 0,001), high pre-TAVI CRP (HR 4.15; 95%CI, 1.3-12.9; p = 0.01), and large blood transfusion [HR 4,68; 1,3-16,7; p = 0.02].
Conclusions:
High pre-TAVI CRP showed to be an independent predictor of 1-year mortality, as well as the presence of ARF and large blood transfusions.
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