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Ramos M, Quezada-Feijoó M, Ayala R, Manzano A, Gómez-Pavón FJ, Jaramillo J, Herrera C, López Vazquez de la Torre M, Toro R. Value of NT-proBNP and Galectin-3 as Biomarkers in the Follow-Up of Asymptomatic Elderly Patients with Severe Aortic Stenosis. J Clin Med 2023; 12:jcm12082987. [PMID: 37109323 PMCID: PMC10146298 DOI: 10.3390/jcm12082987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
Recognizing symptoms in elderly patients with severe aortic stenosis (AS) can be a challenge. Serum biomarkers such as Galectin-3 or N-terminal prohormone B-type natriuretic peptide (NT-proBNP) are involved in remodeling and heart failure (HF) development and could support the diagnosis of AS. We set out to test the usefulness of NT-proBNP and Galectin-3 in predicting events in this population. We designed a prospective observational case-control study, including 50 asymptomatic patients older than 70 years, diagnosed with severe degenerative AS, and 50 control individuals. The NT-proBNP and Galectin-3 levels were measured. A follow-up was carried out at 12 months to determine the occurrence of hospital admission for HF, all-cause mortality or the appearance of symptoms. The patients with severe AS had higher Galectin-3 and NT-proBNP concentrations. The area under the receiver operating characteristic curve of the NT-proBNP was 0.812 (95% CI, 0.646-0.832), and that of the Galectin-3 was 0.633 (95% CI, 0.711-0.913). NT-proBNP was a good predictor of events [HR 3.45 (95% CI 1.32-9.03), p = 0.011]. A Kaplan-Meier analysis showed that the probability of freedom from events was significant in patients who exhibited a combination of higher NT-proBNP and Galectin-3 levels (log-rank p = 0.032). Therefore, NT-proBNP was the most reliable predictor of events in asymptomatic patients with severe AS. A combination of NT-proBNP and Galectin-3 levels may be vital in the clinical follow-up of these patients and in the decision-making process.
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Affiliation(s)
- Mónica Ramos
- Cardiology Department, Hospital Central de la Cruz Roja, C/Reina Victoria, 24, 28003 Madrid, Spain
- Medicine School, Universidad Alfonso X El Sabio, Avda. De la Universidad, 1, Villanueva de la Cañada, 28691 Madrid, Spain
| | - Maribel Quezada-Feijoó
- Cardiology Department, Hospital Central de la Cruz Roja, C/Reina Victoria, 24, 28003 Madrid, Spain
- Medicine School, Universidad Alfonso X El Sabio, Avda. De la Universidad, 1, Villanueva de la Cañada, 28691 Madrid, Spain
| | - Rocío Ayala
- Cardiology Department, Hospital Central de la Cruz Roja, C/Reina Victoria, 24, 28003 Madrid, Spain
- Medicine School, Universidad Alfonso X El Sabio, Avda. De la Universidad, 1, Villanueva de la Cañada, 28691 Madrid, Spain
| | - Ascensión Manzano
- Cardiology Department, Hospital Central de la Cruz Roja, C/Reina Victoria, 24, 28003 Madrid, Spain
| | - Francisco Javier Gómez-Pavón
- Medicine School, Universidad Alfonso X El Sabio, Avda. De la Universidad, 1, Villanueva de la Cañada, 28691 Madrid, Spain
- Geriatric Department, Hospital Central de la Cruz Roja, C/Reina Victoria, 24, 28003 Madrid, Spain
| | - Javier Jaramillo
- Medicine School, Universidad Alfonso X El Sabio, Avda. De la Universidad, 1, Villanueva de la Cañada, 28691 Madrid, Spain
- Geriatric Department, Hospital Central de la Cruz Roja, C/Reina Victoria, 24, 28003 Madrid, Spain
| | - Cristina Herrera
- Biochemistry Laboratory, Hospital Central de la Cruz Roja, C/Reina Victoria, 24, 28003 Madrid, Spain
| | - Mariola López Vazquez de la Torre
- Departmental Section of Biochemistry and Molecular Biology, Faculty of Pharmacy, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Rocío Toro
- Research Unit, Biomedical Research and Innovation Institute of Cadiz (INiBICA), Puerta del Mar University Hospital, Av/Ana de Viya 21, 11009 Cádiz, Spain
- Medicine Department, School of Medicine, Cádiz University, Edificio Andrés Segovia 30 Floor, C/Dr. Marañón S/N, 21001 Cádiz, Spain
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Troponin as a predictor of outcomes in transcatheter aortic valve implantation: systematic review and meta-analysis. Gan To Kagaku Ryoho 2023; 71:12-19. [PMID: 36318400 DOI: 10.1007/s11748-022-01888-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 10/21/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Transcatheter aortic valve implantation (TAVI) is emerging as a therapeutic gold standard in the management of aortic stenosis. However, post-procedural complications of this procedure are being increasingly recognised. We therefore performed this systematic review and meta-analysis on the prognostic value of elevated troponin prior to TAVI to predict risk of post-procedural complications. METHODS We searched Medline (Ovid), Embase (Ovid), and the Cochrane Library from inception until May 2022, and included studies on the association between elevated pre-procedural troponin with 30-day mortality, long-term mortality, and post-procedural myocardial injury (PPMI). We generated summary odds ratios (OR) and hazards ratios (HR) using random-effects meta-analysis and performed subgroup analyses to evaluate differences in troponin threshold selection. Inter-study heterogeneity was tested using the I2 test. RESULTS We included 10 studies involving 4200 patients. Serum troponin elevation prior to TAVI was significantly associated with long-term mortality [HR = 2.09 (95% CI 1.30-3.36)], but not with 30-day mortality [OR 1.76 (95% CI 0.96-3.22)]. Subgroup analysis showed a trend towards increased effect size and statistical significance for 30-day mortality as troponin elevation was more narrowly defined. Two studies reported on PPMI and found no statistically significant mean difference between groups. CONCLUSIONS Raised serum troponin is associated with increased long-term mortality following TAVI. Further clarification on the optimal troponin threshold for risk identification is required. High-quality studies that utilise ROC analysis for threshold selection are warranted.
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Tan ESJ, Oon YY, Chan SP, Liew OW, Chong JPC, Tay E, Soo WM, Yip JWL, Gong L, Lunaria JB, Yong QW, Lee EM, Yeo DPS, Ding ZP, Tang HC, Ewe SH, Chin CCW, Chai SC, Goh PP, Ling LF, Ong HY, Richards AM, Ling LH. Novel predictive role for mid-regional proadrenomedullin in moderate to severe aortic stenosis. Heart 2022; 108:1319-1327. [PMID: 35332049 DOI: 10.1136/heartjnl-2021-320707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/07/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE We investigated the prognostic significance of selected known and novel circulating biomarkers in aortic stenosis (AS). METHODS N-terminal pro-BNP (NT-proBNP), high-sensitivity troponin-T (hsTnT), growth differentiation factor-15 (GDF-15), suppression of tumorigenicity-2 (ST2), mid-regional proadrenomedullin (MR-proADM) and mid-regional proatrial natriuretic peptide (MR-proANP) were measured in patients with moderate to severe AS, New York Heart Association (NYHA) class I-II and left ventricular ejection fraction ≥50%, recruited consecutively across five centres from 2011 to 2018. Their ability to predict both primary (all-cause mortality, heart failure hospitalisation or progression to NYHA class III-IV) and secondary (additionally incorporating syncope and acute coronary syndrome) outcomes was determined by competing risk analyses. RESULTS Among 173 patients with AS (age 69±11 years, 55% male, peak transaortic velocity (Vmax) 4.0±0.8 m/s), the primary and secondary outcomes occurred in 59 (34%) and 66 (38%), respectively. With aortic valve replacement as a competing risk, the primary outcome was determined consistently by the comorbidity index and each selected biomarker except ST2 (p<0.05), independent of NYHA class, Vmax, LV-global longitudinal strain and serum creatinine. MR-proADM had the highest discriminative value for both primary (subdistribution HR (SHR) 11.3, 95% CI 3.9 to 32.7) and secondary outcomes (SHR 12.6, 95% CI 4.7 to 33.5). Prognostic assessment of dual-biomarker combinations identified MR-proADM plus either hsTnT or NT-proBNP as the best predictive model for both clinical outcomes. Paired biomarker models were not superior to those including MR-proADM as the sole circulating biomarker. CONCLUSION MR-proADM most powerfully portended worse prognosis and should be further assessed as possibly the biomarker of choice for risk stratification in AS.
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Affiliation(s)
- Eugene S J Tan
- Department of Cardiology, National University Heart Centre, Singapore.,Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Yen Yee Oon
- Department of Cardiology, National University Heart Centre, Singapore.,Department of Cardiology, Sarawak Heart Center, Sarawak, Malaysia
| | - Siew Pang Chan
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Oi Wah Liew
- Yong Loo Lin School of Medicine, National University Singapore, Singapore.,Cardiovascular Research Institute, National University Heart Centre, Singapore
| | - Jenny P C Chong
- Yong Loo Lin School of Medicine, National University Singapore, Singapore.,Cardiovascular Research Institute, National University Heart Centre, Singapore
| | - Edgar Tay
- Department of Cardiology, National University Heart Centre, Singapore.,Asian Heart & Vascular Centre, Mount Elizabeth Novena Hospital, Singapore
| | - Wern Miin Soo
- Department of Cardiology, National University Heart Centre, Singapore
| | - James W L Yip
- Department of Cardiology, National University Heart Centre, Singapore.,Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Lingli Gong
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | | | - Quek Wei Yong
- Department of Cardiology, Tan Tock Seng Hospital, Singapore
| | - Evelyn Min Lee
- Department of Cardiology, Tan Tock Seng Hospital, Singapore
| | - Daniel P S Yeo
- Department of Cardiology, Tan Tock Seng Hospital, Singapore.,Apex Heart Clinic, Gleneagles Hospital, Singapore
| | - Zee Pin Ding
- Department of Cardiology, National Heart Centre, Singapore
| | - Hak Chiaw Tang
- Department of Cardiology, National Heart Centre, Singapore
| | - See Hooi Ewe
- Department of Cardiology, National Heart Centre, Singapore
| | | | - Siang Chew Chai
- Department of Cardiology, Changi General Hospital, Singapore
| | - Ping Ping Goh
- Asian Heart & Vascular Centre, Mount Elizabeth Novena Hospital, Singapore
| | - Lee Fong Ling
- Department of Cardiology, Khoo Teck Puat Hospital, Singapore
| | - Hean Yee Ong
- Department of Cardiology, Khoo Teck Puat Hospital, Singapore
| | - A Mark Richards
- Department of Cardiology, National University Heart Centre, Singapore.,Yong Loo Lin School of Medicine, National University Singapore, Singapore.,Cardiovascular Research Institute, National University Heart Centre, Singapore.,Christchurch Heart Institute, University of Otago, Dunedin, New Zealand
| | - Lieng Hsi Ling
- Department of Cardiology, National University Heart Centre, Singapore .,Yong Loo Lin School of Medicine, National University Singapore, Singapore.,Cardiovascular Research Institute, National University Heart Centre, Singapore
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White M, Baral R, Ryding A, Tsampasian V, Ravindrarajah T, Garg P, Koskinas KC, Clark A, Vassiliou VS. Biomarkers Associated with Mortality in Aortic Stenosis: A Systematic Review and Meta-Analysis. Med Sci (Basel) 2021; 9:medsci9020029. [PMID: 34067808 PMCID: PMC8163007 DOI: 10.3390/medsci9020029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 12/15/2022] Open
Abstract
The optimal timing of aortic valve replacement (AVR) remains controversial. Several biomarkers reflect the underlying pathophysiological processes in aortic stenosis (AS) and may be of use as mortality predictors. The aim of this systematic review and meta-analysis is to evaluate the blood biomarkers utilised in AS and assess whether they associate with mortality. PubMed and Embase were searched for studies reporting baseline biomarker level and mortality outcomes in patients with AS. A total of 83 studies met the inclusion criteria and were systematically reviewed. Of these, 21 reporting brain natriuretic peptide (BNP), N-terminal pro B-type natriuretic peptide (NT-proBNP), Troponin and Galectin-3 were meta-analysed. Pooled analysis demonstrated that all-cause mortality was significantly associated with elevated baseline levels of BNP (HR 2.59; 95% CI 1.95–3.44; p < 0.00001), NT-proBNP (HR 1.73; 95% CI 1.45–2.06; p = 0.00001), Troponin (HR 1.65; 95% CI 1.31–2.07; p < 0.0001) and Galectin-3 (HR 1.82; 95% CI 1.27–2.61; p < 0.001) compared to lower baseline biomarker levels. Elevated levels of baseline BNP, NT-proBNP, Troponin and Galectin-3 were associated with increased all-cause mortality in a population of patients with AS. Therefore, a change in biomarker level could be considered to refine optimal timing of intervention. The results of this meta-analysis highlight the importance of biomarkers in risk stratification of AS, regardless of symptom status.
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Affiliation(s)
- Madeline White
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7UQ, UK; (M.W.); (R.B.); (A.R.); (T.R.); (P.G.); (A.C.); (V.S.V.)
| | - Ranu Baral
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7UQ, UK; (M.W.); (R.B.); (A.R.); (T.R.); (P.G.); (A.C.); (V.S.V.)
- Norfolk and Norwich University Hospital, Norwich NR4 7UQ, UK
| | - Alisdair Ryding
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7UQ, UK; (M.W.); (R.B.); (A.R.); (T.R.); (P.G.); (A.C.); (V.S.V.)
- Norfolk and Norwich University Hospital, Norwich NR4 7UQ, UK
| | - Vasiliki Tsampasian
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7UQ, UK; (M.W.); (R.B.); (A.R.); (T.R.); (P.G.); (A.C.); (V.S.V.)
- Norfolk and Norwich University Hospital, Norwich NR4 7UQ, UK
- Correspondence:
| | - Thuwarahan Ravindrarajah
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7UQ, UK; (M.W.); (R.B.); (A.R.); (T.R.); (P.G.); (A.C.); (V.S.V.)
| | - Pankaj Garg
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7UQ, UK; (M.W.); (R.B.); (A.R.); (T.R.); (P.G.); (A.C.); (V.S.V.)
- Norfolk and Norwich University Hospital, Norwich NR4 7UQ, UK
| | | | - Allan Clark
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7UQ, UK; (M.W.); (R.B.); (A.R.); (T.R.); (P.G.); (A.C.); (V.S.V.)
| | - Vassilios S. Vassiliou
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7UQ, UK; (M.W.); (R.B.); (A.R.); (T.R.); (P.G.); (A.C.); (V.S.V.)
- Norfolk and Norwich University Hospital, Norwich NR4 7UQ, UK
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Mid-Regional Proadrenomedullin as a New Biomarker of Kidney and Cardiovascular Diseases-Is It the Future? J Clin Med 2021; 10:jcm10030524. [PMID: 33540505 PMCID: PMC7867137 DOI: 10.3390/jcm10030524] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/22/2021] [Accepted: 01/27/2021] [Indexed: 01/19/2023] Open
Abstract
The increasing prevalence of cardiovascular disease and concomitant chronic kidney disease among the aging populations is responsible for considerable growth of mortality. Additionally, frequent, prolonged hospitalizations and long-term treatment generates progressive decline in bodily functions as well as substantial public health and economic burden. Accessibility to easy, non-invasive prognostic markers able to detect patients at risk of cardiovascular events may improve effective therapy and mitigate disease progression. Moreover, an early diagnosis allows time for implementation of prophylactic and educational programs that may result in decreased morbidity, improved quality of life and reduced public health expenditure. One of the promising candidates for a novel cardiovascular biomarker is mid-regional proadrenomedullin, a derivative of adrenomedullin. Adrenomedullin is a peptide hormone known for its vasodilatory, antioxidant, antiapoptotic and antifibrotic effects. A remarkable advantage of mid-regional proadrenomedullin is its longer half-life which is a prerequisite for plasma measurements. These review aims to discuss the importance of mid-regional proadrenomedullin with reference to its usefulness as a biomarker of increased cardiovascular risk and kidney disease progression.
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Takagi H, Kuno T, Hari Y, Nakashima K, Yokoyama Y, Ueyama H, Ando T. Prognostic impact of baseline C‐reactive protein levels on mortality after transcatheter aortic valve implantation. J Card Surg 2020; 35:974-980. [DOI: 10.1111/jocs.14499] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Hisato Takagi
- Department of Cardiovascular SurgeryShizuoka Medical CenterShizuoka Japan
- Department of Cardiovascular SurgeryKitasato University School of MedicineSagamihara Japan
| | - Toshiki Kuno
- Department of MedicineMount Sinai Beth Israel Medical CenterNew York New York
| | - Yosuke Hari
- Department of Cardiovascular SurgeryShizuoka Medical CenterShizuoka Japan
- Department of Cardiovascular SurgeryKitasato University School of MedicineSagamihara Japan
| | - Kouki Nakashima
- Department of Cardiovascular SurgeryShizuoka Medical CenterShizuoka Japan
- Department of Cardiovascular SurgeryKitasato University School of MedicineSagamihara Japan
| | | | - Hiroki Ueyama
- Department of MedicineMount Sinai Beth Israel Medical CenterNew York New York
| | - Tomo Ando
- Division of Interventional Cardiology, Department of Cardiology, New York‐Presbyterian HospitalColumbia University Medical CenterNew York New York
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Takagi H, Hari Y, Nakashima K, Kuno T, Ando T. Meta-analysis of impact of troponins on mortality after transcatheter aortic valve implantation. THE JOURNAL OF CARDIOVASCULAR SURGERY 2020; 61:98-106. [DOI: 10.23736/s0021-9509.19.11023-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Li Y, Pei H, Zhou C, Lou Y. Pre-procedural elevated cardiac troponin predict risk of long-term all-cause mortality after transcatheter aortic valve replacement: a meta-analysis of prospective studies. Biomarkers 2020; 25:164-170. [PMID: 31920111 DOI: 10.1080/1354750x.2020.1714736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Yuehua Li
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hanjun Pei
- Department of Cardiology, The First Affiliated Hospital of Baotou Medical College, Baotou, China
| | - Chenghui Zhou
- Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Lou
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Takagi H, Hari Y, Kawai N, Kuno T, Ando T. Meta-Analysis of Impact of Baseline N-TerminalPro-Brain Natriuretic Peptide Levels on SurvivalAfter Transcatheter Aortic Valve Implantation for Aortic Stenosis. Am J Cardiol 2019; 123:820-826. [PMID: 30587374 DOI: 10.1016/j.amjcard.2018.11.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 11/18/2018] [Accepted: 11/26/2018] [Indexed: 12/20/2022]
Abstract
We performed a meta-analysis of currently available studies investigating impact of baseline N-terminal pro-brain natriuretic peptide (NT-proBNP) on mortality after transcatheter aortic valve implantation (TAVI) for aortic stenosis (AS). MEDLINE and EMBASE were searched through August 2018 using PubMed and OVID. Studies considered for inclusion met the following criteria: the design was a study researching impact of baseline NT-proBNP levels on survival; the study population was patients underwent TAVI for AS; outcomes included all-cause mortality. For each study, we directly extracted odds ratio (ORs) or hazard ratios (HRs) of mortality (for high vs low baseline NT-proBNP); and generated ORs using mortality rates in both patients with high and low levels of baseline NT-proBNP. Study-specific estimates were combined using inverse variance-weighted averages of logarithmic ORs/HRs in the random-effects model. We identified 16 eligible studies including a total of 3,679 patients who underwent TAVI for AS. Pooled analyses demonstrated that high levels of baseline NT-proBNP were associated with a statistically nonsignificant increase in early (30-day or 2-month) mortality (pooled OR, 1.60; 95% confidence interval, 0.84 to 3.04; p = 0.15) and a statistically significant increase in midterm (6-month to 4-year) mortality (pooled OR/HR, 1.88; 95% confidence interval, 1.54 to 2.28; p < 0.00001). Although funnel-plot asymmetry suggesting publication bias was detected, adjusting for funnel-plot asymmetry indicated an association of high levels of baseline NT-proBNP with a still significant increase in midterm mortality. In conclusion, high levels of baseline NT-proBNP predict increased midterm, not early, mortality after TAVI for AS.
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Oury C, Nchimi A, Lancellotti P, Bergler-Klein J. Can Blood Biomarkers Help Predicting Outcome in Transcatheter Aortic Valve Implantation? Front Cardiovasc Med 2018; 5:31. [PMID: 29644220 PMCID: PMC5882866 DOI: 10.3389/fcvm.2018.00031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 03/16/2018] [Indexed: 12/14/2022] Open
Abstract
Transcatheter aortic valve implantation (TAVI) has become the method of choice for patients with severe aortic valve stenosis, who are ineligible or at high risk for surgery. In this high risk patient population, early and late mortality and rehospitalization rates after TAVI are still relatively high. In spite of recent improvements in procedural TAVI, and establishment of risk models for poor outcome, determining individual risk remains challenging. In this context, current data from several small studies strongly suggest that blood biomarkers of myocardial injury, cardiac mechanical stretch, inflammation, and hemostasis imbalance might play an important role by providing informations on patient risk at baseline, and postprocedural progression of patient clinical conditions from days up to years post-TAVI. Although the role of biomarkers for predicting survival post-TAVI remains to be validated in large randomized studies, implementing biomarkers in clinical practice might improve risk stratification, thereby further reducing TAVI-associated morbidity and mortality.
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Affiliation(s)
- Cécile Oury
- Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium
| | - Alain Nchimi
- Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium
| | - Patrizio Lancellotti
- Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
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