Department of Clinical, Internal, Anaesthesiology and Cardiovascular Sciences, 'Sapienza' University of Rome, Policlinico Umberto I, Rome, Italy.
J Cardiovasc Med (Hagerstown). 2022 Jun 1;23(6):394-398. doi: 10.2459/JCM.0000000000001309.
Systemic inflammatory response syndrome (SIRS) could affect mortality after transcatheter aortic valve implantation (TAVI) up to 12 months of follow-up. The aim of this study was to evaluate the prevalence of SIRS after TAVI and its impact on all-cause mortality up to 24 months follow-up.
We retrospectively enrolled 132 patients with symptomatic severe aortic stenosis undergoing TAVI. SIRS development during the first 72 h after the intervention was evaluated. Other postoperative complications were defined according to the Valve Academic Research Consortium 2 (VARC2). All patients underwent follow-up at 30 days and 24 months. Endpoints were 30-days and 24-months mortality.
Post-TAVI SIRS developed in 27 patients (20%). At 30-day follow-up, all-cause death occurred in 10 (8%) patients and SIRS occurred more frequently in patients with adverse short-term outcome (60 vs. 17%; P = 0.001). Twenty-four months all-cause death occurred in 25 (19%) patients. SIRS resulted as an independent predictor of long-term outcome [hazard ratio 3.7; 95% confidence interval (95% CI) 1.5-9; P = 0.004], along with major vascular complications (hazard ratio 4; 95% CI 1.6-9.9; P = 0.003), relevant bleedings (hazard ratio 6.4; 95% CI 1.5-28; P = 0.013) and baseline pulmonary hypertension (hazard ratio 2.4; 95% CI 1.05-5.6; P = 0.039).
Postoperative SIRS was more frequent in patients who died at 30 days follow-up. Moreover, SIRS resulted as a predictor of 24-month mortality along with vascular complications, relevant bleedings and baseline pulmonary hypertension.
全身炎症反应综合征（SIRS）可影响经导管主动脉瓣置换术（TAVI）后 12 个月的死亡率。本研究旨在评估 TAVI 后 SIRS 的发生率及其对 24 个月随访期间全因死亡率的影响。
我们回顾性纳入了 132 例因有症状的重度主动脉瓣狭窄而行 TAVI 的患者。评估了术后 72 小时内 SIRS 的发生情况。根据 Valve Academic Research Consortium 2（VARC2）标准定义了其他术后并发症。所有患者在术后 30 天和 24 个月进行随访。终点为 30 天和 24 个月的死亡率。
132 例患者中有 27 例（20%）发生了 TAVI 后 SIRS。在 30 天随访时，10 例（8%）患者发生了全因死亡，且 SIRS 患者的短期不良结局发生率更高（60% vs. 17%；P=0.001）。25 例（19%）患者在 24 个月时发生了全因死亡。SIRS 是长期预后的独立预测因素[风险比 3.7；95%置信区间（95%CI）1.5-9；P=0.004]，与大血管并发症（风险比 4；95%CI 1.6-9.9；P=0.003）、相关出血（风险比 6.4；95%CI 1.5-28；P=0.013）和基线肺动脉高压（风险比 2.4；95%CI 1.05-5.6；P=0.039）有关。
在 30 天随访时死亡的患者中，术后 SIRS 更为常见。此外，SIRS 是 24 个月死亡率的预测因素，与血管并发症、相关出血和基线肺动脉高压有关。
