Abstract
ObjectiveTo evaluate the prognostic value of C-reactive protein to albumin ratio (CAR) in patients with severe aortic valve stenosis undergoing surgical aortic valve replacement (AVR).MethodsFour hundred seventy-six patients with severe degenerative aortic stenosis who underwent successful isolated surgical AVR were enrolled. Hospitalization due to heart failure, surgical aortic reoperation, paravalvular leakage rates, and long-term mortality were evaluated in the whole study group. The participants were divided into two groups, as 443 patients without mortality (group 1) and 33 patients with mortality (group 2) during the follow-up time.ResultsCAR was lower in patients without mortality than in those with mortality during the follow-up time (0.84 [0.03-23.43] vs. 2.50 [0.22-26.55], respectively, P<0.001). Age (odds ratio [OR]: 1.062, confidence interval [CI]: 1.012-1.114, P=0.014), CAR (OR: 1.221, CI: 1.125-1.325, P<0.001), ejection fraction (OR: 0.956, CI: 0.916-0.998, P=0.042), and valve type (OR: 2.634, CI: 1.045-6.638, P=0.040) were also found to be independent predictors of long-term mortality. Additionally, rehospitalization (0.86 [0.03-26.55] vs. 1.6 [0.17-24.05], P=0.006), aortic reoperation (0.87 [0.03-26.55] vs. 1.6 [0.20-23.43], P=0.016), and moderate to severe aortic paravalvular leakage (0.86 [0.03-26.55] vs. 1.86 [0.21-19.50], P=0.023) ratios were associated with higher CAR.ConclusionIt was firstly described that CAR was strongly related with increased mortality rates in patients with isolated severe aortic stenosis after surgical AVR. Additionally, rehospitalization, risk of paravalvular leakage, and aortic reoperation rates were higher in patients with increased CAR than in those without it.
Highlights
Aortic stenosis is the most common form of degenerative valvular heart disease, with increasing prevalence, and it is still the leading cause of surgical valve replacement therapy, especially in developing countries[1]
It was firstly described that CRP to albumin ratio (CAR) was strongly related with increased mortality rates in patients with isolated severe aortic stenosis after surgical aortic valve replacement (AVR)
We aimed to evaluate the prognostic value of CAR on clinical events in patients with isolated severe degenerative aortic stenosis undergoing surgical AVR
Summary
Aortic stenosis is the most common form of degenerative valvular heart disease, with increasing prevalence, and it is still the leading cause of surgical valve replacement therapy, especially in developing countries[1]. The chronic inflammatory process plays an important role on atherosclerosis, an uncontested underlying pathogenic mechanism of degenerative valvular aortic stenosis. It was demonstrated that serum CRP levels predict progression and severity of aortic stenosis due to the pathogenic role of inflammation on valvular disease[3]. While inflammatory markers have been evaluated on severity and prognosis of aortic stenosis, they have not been adequately studied to determine their effect on the prognosis after aortic valve replacement (AVR) therapy.
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