Bogdan Andrada, Barbash Israel M, Segev Amit, Fefer Paul, Bogdan Stefan Nicolae, Asher Elad, Fink Noam, Hamdan Ashraf, Spiegelstein Dan, Raanani Ehud, Guetta Victor
Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel.
EuroIntervention. 2016 Oct 10;12(8):e1057-e1064. doi: 10.4244/EIJY15M10_09.
Albumin is a marker of frailty. Scarce data are available on correlations between frailty-related parameters and outcomes in patients undergoing TAVI. This study sought to evaluate the relation between albumin and mortality in TAVI candidates.
A total of 150 patients (mean age 81±6 years) undergoing TAVI were included in the study. Patients with pre-procedural albumin >4 g/dl (>40 g/L) (n=71) were compared to those ≤4 g/dl (≤40 g/L) (n=79). The cut-off value of 4 g/dl (40 g/L) was based on the mean value of albumin in the patients included in the study. During a mean follow-up of 2.1 years the survival rate was 72%. Patients in both groups had similar baseline characteristics. The 2.1-year mortality was higher in the low albumin group compared with the normal albumin group (35% vs. 19%, p=0.01). Multivariate analysis indicated that low pre-procedural albumin was independently associated with a more than twofold increase in 2.1-year all-cause mortality (p=0.01, HR=2.28; 95% CI: 1.17-4.44). Low post-procedural serum albumin remained a strong parameter correlated with all-cause mortality (HR=2.47; 95% CI: 1.28-4.78; p<0.01).
Baseline albumin can be used as a simple tool that correlates with survival after TAVI. Low albumin is an important parameter associated with all-cause mortality after the procedure.
白蛋白是衰弱的一个标志物。关于接受经导管主动脉瓣植入术(TAVI)患者的衰弱相关参数与预后之间的相关性,现有数据稀缺。本研究旨在评估TAVI候选患者中白蛋白与死亡率之间的关系。
本研究纳入了总共150例接受TAVI的患者(平均年龄81±6岁)。将术前白蛋白>4 g/dl(>40 g/L)的患者(n = 71)与白蛋白≤4 g/dl(≤40 g/L)的患者(n = 79)进行比较。4 g/dl(40 g/L)的临界值基于纳入研究患者的白蛋白平均值。在平均2.1年的随访期间,生存率为72%。两组患者的基线特征相似。低白蛋白组的2.1年死亡率高于正常白蛋白组(35%对19%,p = 0.01)。多变量分析表明,术前低白蛋白与2.1年全因死亡率增加两倍以上独立相关(p = 0.01,HR = 2.28;95%CI:1.17 - 4.44)。术后低血清白蛋白仍然是与全因死亡率相关的一个重要参数(HR = 2.47;95%CI:1.28 - 4.78;p < 0.01)。
基线白蛋白可作为一种与TAVI术后生存相关的简单工具。低白蛋白是该手术后与全因死亡率相关的一个重要参数。