BACKGROUND: Neutrophil-lymphocyte (NLR) and platelet-lymphocyte ratios (PLR) mark systemic inflammation. Patients with high NLR and PLR have worse cardiovascular disease and outcomes. We assessed the role of these ratios in predicting outcomes after transcatheter aortic valve replacement (TAVR). METHODS: The association between NLR and PLR with baseline characteristics, 30-day outcomes, and 1-year readmission/survival was determined in patients that underwent TAVR between 2007 and 2014 and had baseline complete blood count with differential. A subgroup analysis determined the association between change in NLR and PLR (discharge-baseline) and 1-year outcomes. RESULTS: In 520 patients that underwent TAVR, a higher NLR (p=0.01) and PLR (p=0.02) were associated with a higher STS-PROM score, and with increased occurrence of the 30-day early-safety outcome (by VARC-2), even after adjusting for STS-PROM score, valve generation (Sapien vs. Sapien XT), and access (transfemoral vs. non-transfemoral) (NLR: OR 1.29, 95% CI 1.04-1.61; PLR: OR 1.27, 95% CI 1.01-1.60) but not with 1-year readmission or survival. In our subgroup analysis (N=294), change in PLR was not associated with the 1-year outcomes but a high change in NLR was associated with worse 1-year survival/readmission and 1-year survival, even after adjusting for STS-PROM score, valve generation and access (HR 1.22, 95% CI 1.04-1.44 and HR 1.26, 95% CI 0.99-1.6, respectively). CONCLUSIONS: NLR and PLR correlate with surgical risk. An elevated NLR and PLR were associated with the occurrence of 30-day adverse outcomes, similar to the STS-PROM score. A high variation of NLR from baseline to discharge may help stratify patients that underwent TAVR in addition to traditional risk factors.
BACKGROUND: Neutrophil-lymphocyte (NLR) and platelet-lymphocyte ratios (PLR) mark systemic inflammation. Patients with high NLR and PLR have worse cardiovascular disease and outcomes. We assessed the role of these ratios in predicting outcomes after transcatheter aortic valve replacement (TAVR). METHODS: The association between NLR and PLR with baseline characteristics, 30-day outcomes, and 1-year readmission/survival was determined in patients that underwent TAVR between 2007 and 2014 and had baseline complete blood count with differential. A subgroup analysis determined the association between change in NLR and PLR (discharge-baseline) and 1-year outcomes. RESULTS: In 520 patients that underwent TAVR, a higher NLR (p=0.01) and PLR (p=0.02) were associated with a higher STS-PROM score, and with increased occurrence of the 30-day early-safety outcome (by VARC-2), even after adjusting for STS-PROM score, valve generation (Sapien vs. Sapien XT), and access (transfemoral vs. non-transfemoral) (NLR: OR 1.29, 95% CI 1.04-1.61; PLR: OR 1.27, 95% CI 1.01-1.60) but not with 1-year readmission or survival. In our subgroup analysis (N=294), change in PLR was not associated with the 1-year outcomes but a high change in NLR was associated with worse 1-year survival/readmission and 1-year survival, even after adjusting for STS-PROM score, valve generation and access (HR 1.22, 95% CI 1.04-1.44 and HR 1.26, 95% CI 0.99-1.6, respectively). CONCLUSIONS: NLR and PLR correlate with surgical risk. An elevated NLR and PLR were associated with the occurrence of 30-day adverse outcomes, similar to the STS-PROM score. A high variation of NLR from baseline to discharge may help stratify patients that underwent TAVR in addition to traditional risk factors.
Authors: Ignacio M Seropian; Francisco J Romeo; Rodolfo Pizarro; Norberto O Vulcano; Ricardo A Posatini; Ricardo G Marenchino; Daniel H Berrocal; Cesar A Belziti Journal: ESC Heart Fail Date: 2017-07-31
Authors: Bahira Shahim; Björn Redfors; Brian R Lindman; Shmuel Chen; Torsten Dahlen; Tamim Nazif; Samir Kapadia; Zachary M Gertz; Aaron C Crowley; Ditian Li; Vinod H Thourani; Susheel K Kodali; Alan Zajarias; Vasilis C Babaliaros; Robert A Guyton; Sammy Elmariah; Howard C Herrmann; David J Cohen; Michael J Mack; Craig R Smith; Martin B Leon; Isaac George Journal: J Am Heart Assoc Date: 2022-06-03 Impact factor: 6.106
Authors: Fakiha Siddiqui; Alberto García-Ortega; Bulent Kantarcioglu; James Sinacore; Alfonso Tafur; Pablo Demelo-Rodríguez; José Antonio Nieto; Esther Usandizaga; Jawed Fareed; Manuel Monreal Journal: Clin Appl Thromb Hemost Date: 2022 Jan-Dec Impact factor: 3.512
Authors: Haitham Abu Khadija; Gera Gandelman; Omar Ayyad; Mustafa Jaber; Lion Poles; Michael Jonas; Offir Paz; Firas Abu Sbaih; Gal Sella; Sara Shimoni; Jacob George; Alex Blatt Journal: PLoS One Date: 2021-10-26 Impact factor: 3.240