Can Blood Biomarkers Help Predicting Outcome in Transcatheter Aortic Valve Implantation?

Oury, Cécile; Nchimi, Alain; Lancellotti, Patrizio; Bergler‐Klein, Jutta

doi:10.3389/fcvm.2018.00031

Cited by 13 publications

(12 citation statements)

References 68 publications

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“…In view of these considerations, several groups have been encouraged to investigate whether imaging or circulating biomarkers can improve risk stratification in TAVR, including cardiac troponins, brain natriuretic peptides, growth differentiation factor‐15 (GDF‐15), among others 6,7 …”

Section: Introductionmentioning

confidence: 99%

Additive prognostic value of carbohydrate antigen‐125 over frailty in patients undergoing transcatheter aortic valve replacement

Romeo

Seropián

Chiabrando

et al. 2020

Cathet Cardio Intervent

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Background To evaluate the additive prognostic value of myocardial, inflammatory, and renal biomarkers according to frailty status in patients undergoing transcatheter aortic valve replacement (TAVR) for aortic stenosis (AS). Methods A total of 111 subjects who underwent TAVR at Hospital Italiano de Buenos Aires, Argentina between January 2016 and December 2018 were retrospectively reviewed. Plasma levels of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP), high sensitivity troponin T (hs‐cTnT), C‐reactive protein (CRP), cystatin‐c (Cys‐C) and carbohydrate antigen‐125 (CA‐125) were assessed prior to TAVR. Frailty status was assessed according to the fried physical frailty phenotype (FPFP). The primary endpoint was defined as all‐cause death and/or readmission for worsening congestive heart failure (CHF) within the first year after TAVR. Results Of the 111 patients included, 48/111 (43%) were considered to be “frail” according to the FPFP. Among biomarkers, we found CA‐125 to be strongly associated with the primary endpoint (p = .006). CA‐125 ≥ 18.2 U/ml was present in 41% and was associated with a higher rate of the primary endpoint (31% vs. 9%; p = .003). After multivariable adjustment, CA‐125 ≥ 18.2 U/ml (hazard ratio [HR] 3.17; p = .024) was the only independent predictor of the primary endpoint. Finally, the inclusion of CA‐125 to frailty significantly improved C‐index (0.68–0.74; p < .05), and provided a Net Reclassification Improvement (NRI) of 0.34 (95% CI 0.19–0.49, p = .031), largely through reductions in risk estimates among pre‐frail and frail patients. Conclusions CA‐125, a tumor biomarker, outperformed frailty for predicting the primary endpoint within the first year after TAVR.

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Section: Introductionmentioning

confidence: 99%

Additive prognostic value of carbohydrate antigen‐125 over frailty in patients undergoing transcatheter aortic valve replacement

Romeo

Seropián

Chiabrando

et al. 2020

Cathet Cardio Intervent

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“…In recent years, biomarkers have emerged as important tools for these roles in varied cardiovascular diseases including patients with severe aortic stenosis prior to the intervention. As such, several promising biomarkers are under scientific investigation for clinical application, including proBNP [39], NT-proBNP [15,[40][41][42][43][44][45], BNP [45,46], CRP [45,46], cardiac troponin [45], microRNA [46], von Willebrand factor [45], GAL-3, MPV, and others [45,46].…”

Section: Discussionmentioning

confidence: 99%

Pre- and Post-Transcatheter Aortic Valve Replacement Serum Brain Natriuretic Peptide Levels and All-Cause Mortality

et al. 2020

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Background: Risk stratification in patients post-transcatheter aortic valve replacement (TAVR) is limited to and is based on clinical judgment and surgical scoring systems. Serum natriuretic peptides are used for general risk stratification in patients with aortic stenosis, reflecting the increase in their afterload and thereby stressing the need for valve intervention. The objective of this study was to determine the predictive value of pre- and post-procedural serum brain natriuretic peptide (BNP) on 1-year all-cause mortality in patients who underwent TAVR. Methods: In this population-based study, we included 148 TAVR patients treated at the Poriya Medical Center between June 1, 2015, and May 31, 2018. Routine blood samples for serum BNP levels (pg/mL) were taken just before the TAVR and 24 h post-TAVR. Our primary clinical outcome was defined as 1-year all-cause mortality. We used backward regression models and included all variables that had a p value <0.1 in the univariable analysis. A receiver-operating characteristic curve was calculated for the prediction of all-cause mortality by serum BNP levels using the median as the cut-off point. Results: In this study cohort, BNP levels 24 h post-TAVR higher than the cohort median versus lower than the cohort median (387.5 pg/mL; IQR 195–817.6) were the strongest predictor of 1-year mortality (hazard ratio 9; 95% CI 2.72–30.16; p < 0.001). The statistically significant relationship was seen in the unadjusted regression model as well as after the adjustment for clinical variables. Conclusions: Serum BNP levels 24 h post-procedure were found to be a meaningful marker in predicting 1-year all-cause mortality in patients after TAVR procedure.

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“…Several studies have already identified clinical parameters and biomarkers that may improve patient risk stratification (e.g. CK-MB, high-sensitivity Troponin T, BNP and NT-proBNP) [ 6 ]. In addition, there are also surgical risk prediction models such as the logistic EuroSCORE (Log ES), its revised and updated version EuroSCORE II, and the Society of Thoracic Surgeons (STS) score [ 7 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

Improvement of renal function after transcatheter aortic valve replacement and its impact on survival

et al. 2021

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Background Chronic kidney disease as well as acute kidney injury are associated with adverse outcomes after transcatheter aortic valve replacement (TAVR). However, little is known about the prognostic implications of an improvement in renal function after TAVR. Methods Renal improvement (RI) was defined as a decrease in postprocedural creatinine in μmol/l of ≥1% compared to its preprocedural baseline value. A propensity score representing the likelihood of RI was calculated to define patient groups which were comparable regarding potential confounders (age, sex, BMI, NYHA classification, STS score, log. EuroSCORE, history of atrial fibrillation/atrial flutter, pulmonary disease, previous stroke, CRP, creatinine, hsTNT and NT-proBNP). The cohort was stratified into 5 quintiles according to this propensity score and the survival time after TAVR was compared within each subgroup. Results Patients in quintile 5 (n = 93) had the highest likelihood for RI. They were characterized by higher creatinine, lower eGFR, higher NYHA class, higher NT-proBNP, being mostly female and having shorter overall survival time. Within quintile 5, patients without RI had significantly shorter survival compared to patients with RI (p = 0.002, HR = 0.32, 95% CI = [0.15–0.69]). There was no survival time difference between patients with and without RI in the whole cohort (p = 0.12) and in quintiles 1 to 4 (all p > 0.16). Analyses of specific subgroups showed that among patients with NYHA class IV, those with RI also had a significant survival time benefit (p < 0.001, HR = 0.15; 95%-CI = [0.05–0.44]) compared to patients without RI. Conclusions We here describe a propensity score-derived specific subgroup of patients in which RI after TAVR correlated with a significant survival benefit.

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Can Blood Biomarkers Help Predicting Outcome in Transcatheter Aortic Valve Implantation?

Cited by 13 publications

References 68 publications

Additive prognostic value of carbohydrate antigen‐125 over frailty in patients undergoing transcatheter aortic valve replacement

Additive prognostic value of carbohydrate antigen‐125 over frailty in patients undergoing transcatheter aortic valve replacement

Pre- and Post-Transcatheter Aortic Valve Replacement Serum Brain Natriuretic Peptide Levels and All-Cause Mortality

Improvement of renal function after transcatheter aortic valve replacement and its impact on survival

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