Neutrophil-to-Lymphocyte Ratio as a Prognostic Marker in Transcatheter Aortic Valve Implantation (TAVI) Patients

Neutrophil-to-lymphocyte ratio (NLR) is a simple and cost-effective marker of inflammation. This marker has been shown to predict cardiac arrhythmias, progression of valvular heart disease, congestive heart failure decompensation, acute kidney injury, and mortality in cardiovascular patients. The pa...

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Published in:The Israel Medical Association journal 2022-04, Vol.24 (4), p.229-234
Main Authors: Merdler, Ilan, Frydman, Shir, Sirota, Svetlana, Halkin, Amir, Steinvil, Arie, Toledano, Ella, Konigstein, Maayan, Litmanowicz, Batia, Bazan, Samuel, Wenkert, Atalia, Sadon, Sapir, Banai, Shmuel, Finkelstein, Ariel, Arbel, Yaron
Format: Article
Language:English
Subjects:
Aortic Valve - surgery
Aortic Valve Stenosis - complications
Aortic Valve Stenosis - diagnosis
Aortic Valve Stenosis - surgery
Humans
Inflammation - complications
Lymphocytes
Neutrophils
Prognosis
Risk Factors
Transcatheter Aortic Valve Replacement - adverse effects
Transcatheter Aortic Valve Replacement - methods
Treatment Outcome
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Summary:Neutrophil-to-lymphocyte ratio (NLR) is a simple and cost-effective marker of inflammation. This marker has been shown to predict cardiac arrhythmias, progression of valvular heart disease, congestive heart failure decompensation, acute kidney injury, and mortality in cardiovascular patients. The pathologic process of aortic stenosis includes chronic inflammation of the valve and therefore biomarkers of inflammation might offer additive prognostic value. To evaluate NLR and its association with long term mortality in transcatheter aortic valve implantation (TAVI) patients. We evaluated data of 1152 consecutive patient from the Tel Aviv Medical Center TAVI registry who underwent TAVI. Data included baseline clinical, demographic, and echocardiographic findings; procedural complications; and post-procedure mortality. Patients were compared by using the median NLR value (4.1) and evaluated for long-term mortality. Patients with NLR above the median had higher mortality rates (26.4% vs. 16.3%, P < 0.001) at 3 years post-procedure. A multivariable analysis found NLR to be an independent risk factor for mortality (hazard ratio = 1.47, 95% confidence interval 1.09-1.99, P = 0.013). In addition, high NLR was linked to complicationsduring and after the procedure. NLR is an independent prognostic marker among TAVI patients. This marker may represent an increased inflammatory response and should be added to previous known prognostic factors.
ISSN:1565-1088