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Cardiologia Croatica, Vol. 19 No. 11-12, 2024.

Meeting abstract

https://doi.org/10.15836/ccar2024.454

The role of RDW/albumin and CRP/albumin ratios in long term outcomes after transcatheter aortic valve implantation

Petra Bistrović orcid id orcid.org/0000-0002-3650-3297 ; Dubrava University Hospital, Zagreb, Croatia
Miroslav Raguž orcid id orcid.org/0000-0003-1567-8503 ; Dubrava University Hospital, Zagreb, Croatia
Ante Lisičić orcid id orcid.org/0000-0002-4365-9652 ; Dubrava University Hospital, Zagreb, Croatia
Tomislav Šipić orcid id orcid.org/0000-0001-8652-4523 ; Dubrava University Hospital, Zagreb, Croatia
Petra Vitlov orcid id orcid.org/0000-0001-6983-1409 ; Dubrava University Hospital, Zagreb, Croatia
Tomislava Bodrožić-Džakić Poljak orcid id orcid.org/0000-0002-7293-3972 ; Dubrava University Hospital, Zagreb, Croatia
Katarina Bistrović orcid id orcid.org/0009-0002-8409-4210 ; University of Zagreb, School of Medicine, Zagreb, Croatia
Ivan Zeljković orcid id orcid.org/0000-0002-4550-4056 ; Dubrava University Hospital, Zagreb, Croatia
Šime Manola orcid id orcid.org/0000-0001-6444-2674 ; Dubrava University Hospital, Zagreb, Croatia
Irzal Hadžibegović orcid id orcid.org/0000-0001-8791-4910 ; Dubrava University Hospital, Zagreb, Croatia
Ivana Jurin orcid id orcid.org/0000-0002-2637-9691 ; Dubrava University Hospital, Zagreb, Croatia

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Abstract

Keywords

red cell width distribution; C-reactive protein; albumin; transcatheter aortic valve implantation

Hrčak ID:

328008

URI

https://hrcak.srce.hr/328008

Publication date:

13.12.2024.

Visits: 353 *

Copyright statement: Croatian Cardiac Society

Copyright: 2024, Croatian Cardiac Society

Date received: 01 October 2024

Date: 31 October 2024

Publication date: November 2024

Publication date: November 2024

Volume: 19

Issue: 11-12

Pages: 454-455

Publisher ID: CC 2024 19_11-12_454-5

DOI: 10.15836/ccar2024.454

Article Information (continued)

Categories:

Subject: Extended Abstract

Categories:

Subject: Valvular heart disease

KEYWORDS: :

KEYWORDS:

Keyword: red cell width distribution

Keyword: C-reactive protein

Keyword: albumin

Keyword: transcatheter aortic valve implantation

The role of RDW/albumin and CRP/albumin ratios in long term outcomes after transcatheter aortic valve implantation

[https://orcid.org/0000-0002-3650-3297] Petra Bistrović[1][*]

[https://orcid.org/0000-0003-1567-8503] Miroslav Raguž[1]

[https://orcid.org/0000-0002-4365-9652] Ante Lisičić[1]

[https://orcid.org/0000-0001-8652-4523] Tomislav Šipić[1]

[https://orcid.org/0000-0001-6983-1409] Petra Vitlov[1]

[https://orcid.org/0000-0002-7293-3972] Tomislava Bodrožić-Džakić Poljak[1]

[https://orcid.org/0009-0002-8409-4210] Katarina Bistrović[2]

[https://orcid.org/0000-0002-4550-4056] Ivan Zeljković[1]

[https://orcid.org/0000-0001-6444-2674] Šime Manola[1]

[https://orcid.org/0000-0001-8791-4910] Irzal Hadžibegović[1]

[https://orcid.org/0000-0002-2637-9691] Ivana Jurin[1]

 

[1] Dubrava University Hospital, Zagreb, Croatia

[2] University of Zagreb, School of Medicine, Zagreb, Croatia

Author notes:

Correspondence to: [*] ADDRESS FOR CORRESPONDENCE: Petra Bistrović, Klinička bolnica Dubrava, Avenija Gojka Šuška 6, HR-10000 Zagreb, Croatia. / Phone: +385-1-2903-650 / E-mail: pbistrovic@gmail.com

Introduction: Chronic inflammation has been associated with adverse long-term outcomes in transcatheter aortic valve implantation (TAVI) patients, however no specific markers have yet been validated. (1) Previous research has shown a potential impact of RDW/albumin (RAR) and CRP/albumin (CAR) on mortality and complications in diseases such as myocardial infarction and COVID-19. Research on these parameters is scarce in chronic diseases, and so far RAR and CAR have not been studied in TAVI patients. The aim of our research is to determine if RAR and CAR have effects on survival and complications post-TAVI.

Patients and Methods: Our study included 547 patients who underwent TAVI at Dubrava University Hospital from 2012 do 2024, followed to present date. RDW, CRP and albumin were collected through routine blood samples drawn at admission. Using ROC analysis, we determined cut-off values for RDW/albumin (0.35) and CRP/albumin (0.08). Primary outcome of the study was all-cause death in follow up and secondary outcome was major adverse cardiac event (MACE) in follow up. Data was collected through in-person visits and telephone check-ups.

Results: Sociodemographic and clinical characteristics of the patients are shown inTable 1. Median RAR was 0.35 (IQR 0.32-0.40), while median CAR was 0.08 (IQR 0.03-0.17). Our analysis showed a significant difference in survival post-TAVI in patients with elevated RAR (14 vs 45 months, P 0.001; HR 2.61, 95% CI 1.79-3.82) and CAR (15 vs 23 months, P 0.017; HR 1.55, 95% CI 1.08-2.24). There was no difference in MACE during follow-up in either group.

TABLE 1 Patient characteristics.
VariableAll patientsCRP/albumin <0.08CRP/albumin >=0.08P valueRDW/albumin<0.35RDW/albumin >=0.35P value
Age (years)80 (76-83)80 (77-84)80 (75-83)0.016*80 (76-83)80 (76-84)0.308
Male289 (51.6%)161 (53.3%)119 (49.4%)0.363147 (56,5%)133 (47.2%)0.029*
Diabetes mellitus207 (37%)106 (35.1%)97 (40.4%)0.20488 (33.8%)115 (40.9%)0.090
Arterial hypertension489 (87,3%)261 (86.4%)211 (87.6%)0.699230 (88.5%)242 (85.8%)0.359
Cerebrovascular insult55 (9.8%)26 (8.6%)27 (11.3%)0.30425 (9.6%)28 (10%)0.891
COPD68 (12.1%)29 (9.6%)39 (16.2%)0.021*27 (10.4%)41 (14.5%)0.145
eGFR (ml/min/1.73m2)56.8 (41.2-73.0)60.3 (44.8-73.5)52.6 (36.2-71.9)0.001*59.7 (44.9-72.8)53 (36.7-72.7)0.015*
Atrial fibrillation228 (40.7%)111 (36.8%)112 (46.5%)0.022*88 (33.8%)135 (47.9%)0.001*
Hemoglobin (mg/dl)128 (116-138)130 (119-139)125 (112-136)0.003*133 (124-143)121 (109-133)0.001*
Hematocrit (%)39 (35-42)39 (36-42)38 (34-41)0.011*40 (37-43)37 (34-41)0.001*
Platelets (10^6)206.5 (166.5-252.0)193 (164-230)224 (172-279)0.001*207 (168-248)206 (166-258)0.770
CRP (mg/L)2.9 (1.3-7.0)1.5 (0.9-2.4)8.00 (4.88-16.00)0.001*2.1 (1.0-4.5)4.0 (1.9-11.2)0.001*
RDW (%)14.4 (13.7-15.7)14.2 (13.6-15.3)14.9 (14.1-16.2)0.001*13.8 (13.4-14.3)15.7 (14.6-16.9)0.001*
Serum albumin (g/L)41 (39-44)42 (40-44)39 (37-43)0.001*43 (42-45)39 (37-41)0.001*
NTproBNP (pg/nl)2280 (761-5508)1452 (561-3873)3919 (1169-8854)0.001*1372 (546-3569)3164 (1015-8036)0.001*
PAD197 (35.2%)103 (34.2%)91 (37.8%)0.39399 (38.2%)95 (33.7%)0.272
Coronary artery disease106 (20.3%)60 (21.4%)43 (19%)0.50553 (21.7%)50 (19.2%)0.475
LVEF (%)55 (45-60)58 (50-63%)55 (40-60)0.001*59 (50-65)54 (40-60)0.001*
meanPG (mmHg)47 (38-59)47 (40-59)46 (36-59)0.284448 (40-59)46 (37-58)0.106
RDW/albumin0.35 (0.32-0.40)0.34 (0.32-0.37)0.38 (0.34-0.44)0.001*0.32 (0.31-0.34)0.40 (0.37-0.82)0.001*
CRP/albumin0.07 (0.03-0.17)0.04 (0.02-0.06)0.19 (0.12-0.41)0.001*0.05 (0.02-0.11)0.10 (0.05-0.28)0.001*
Numerical values are displayed as median and interquartile range. Categorical values are displayed as numbers and percentages. *Denotes statistical significance, P<0.05; COPD-Chronic obstructive pulmonary disease; eGFR-estimated glomerular filtration rate; CRP-C reactive protein; Red cell distribution width; PAD-Peripheral atherosclerotic disease; LVEF-Left ventricular ejection fraction; meanPG-Mean pressure gradient.

Conclusion: CAR and RAR are derived from parameters used in routine practice that can be easily utilized and have the potential to be used as predictive markers of survival post-TAVI. Further research is neccessary to establish exact cut-off values for TAVI patients, allowing for use in clicinal practice, which in turn could impact how we treat patients at risk.

LITERATURE

1 

Hoffmann J, Mas-Peiro S, Berkowitsch A, Boeckling F, Rasper T, Pieszko K, et al. Inflammatory signatures are associated with increased mortality after transfemoral transcatheter aortic valve implantation. ESC Heart Fail. 2020 October;7(5):2597–610. https://doi.org/10.1002/ehf2.12837 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/32639677

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