Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) can risk stratify patients in transcatheter aortic-valve replacement (TAVR)

Autor: Jessica Forcillo, James Stewart, Jose N. Binongo, Christian F. Witzke-Sanz, Parichart Junpaparp, Chandan Devireddy, Kreton Mavromatis, Bradley G. Leshnower, Ateet Patel, Janani Rangaswami, Jose F. Condado, Yi Lasanajak, Peter C. Block, Vinod H. Thourani, David S. Wheeler, Robert A. Guyton, Vasilis Babaliaros
Rok vydání: 2016
Předmět:
Blood Platelets
Male
medicine.medical_specialty
Transcatheter aortic
Neutrophils
Lymphocyte
medicine.medical_treatment
Subgroup analysis
030204 cardiovascular system & hematology
Transcatheter Aortic Valve Replacement
03 medical and health sciences
Leukocyte Count
0302 clinical medicine
Postoperative Complications
Valve replacement
Risk Factors
Internal medicine
medicine
Humans
030212 general & internal medicine
Lymphocytes
Platelet lymphocyte ratio
Aged
Retrospective Studies
Aged
80 and over
medicine.diagnostic_test
business.industry
Platelet Count
fungi
Complete blood count
Aortic Valve Stenosis
Prognosis
Surgical risk
United States
Surgery
body regions
Survival Rate
medicine.anatomical_structure
Baseline characteristics
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Zdroj: International journal of cardiology. 223
ISSN: 1874-1754
Popis: 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.
Databáze: OpenAIRE
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