Nair Sachin, Ha Francis J, Baradi Arul, Nanayakkara Shane, Soden Lucy, Jin David, Whitbourn Robert, Wilson Andrew, Palmer Sonny
Department of Cardiology, St Vincent's Hospital Melbourne, Fitzroy, Vic, Australia.
Department of Cardiology, St Vincent's Hospital Melbourne, Fitzroy, Vic, Australia.
Heart Lung Circ. 2024 Dec;33(12):1680-1687. doi: 10.1016/j.hlc.2024.07.006. Epub 2024 Oct 8.
Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are simple biomarkers that reflect systemic inflammation and are associated with adverse cardiovascular disease outcomes. The utility of NLR and PLR for risk prediction following transcatheter aortic valve implantation (TAVI) is not clear.
We retrospectively analysed a prospectively maintained database of patients who underwent TAVI at a tertiary hospital from 2009 to 2022. Baseline demographics, NLR, PLR and Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) scores were obtained. The 30-day and 1-year survival rates were analysed using a logistic regression model while overall survival was analysed using the Kaplan-Meier method. Predictors of survival were calculated using a Cox-hazards regression model and presented as odds ratio (OR) with 95% confidence interval (CI).
Overall, 367 patients were included in this study (mean age 84 years, 51% male). Median follow-up was 19 months (interquartile range 8.8-40 months) with a median survival of 7.2 years (interquartile range 3.5-10.3 years). NLR was associated with 30-day mortality (OR 1.75; 95% CI 1.25-2.68; p<0.01). PLRs marginally predicted 1-year mortality (OR 1.01; 95% CI 1.00-1.02). However, only the STS-PROM score significantly predicted overall survival (hazard ratio 1.07; 95% CI 1.02-1.12; p=0.03) after adjustment for NLR and PLR.
NLR is associated with 30-day mortality following TAVI. PLR was not a clinically significant predictor of mortality after TAVI. Only the STS-PROM score remained a significant predictor of overall survival.
中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）是反映全身炎症的简单生物标志物，与不良心血管疾病结局相关。NLR和PLR在经导管主动脉瓣植入术（TAVI）后风险预测中的效用尚不清楚。
我们回顾性分析了一家三级医院2009年至2022年接受TAVI患者的前瞻性维护数据库。获取基线人口统计学数据、NLR、PLR和胸外科医师协会预测死亡率（STS-PROM）评分。使用逻辑回归模型分析30天和1年生存率，同时使用Kaplan-Meier方法分析总生存率。使用Cox风险回归模型计算生存预测因子，并以比值比（OR）和95%置信区间（CI）表示。
总体而言，本研究纳入了367例患者（平均年龄84岁，51%为男性）。中位随访时间为19个月（四分位间距8.8 - 40个月），中位生存期为7.2年（四分位间距3.5 - 10.3年）。NLR与30天死亡率相关（OR 1.75；95% CI 1.25 - 2.68；p<0.01）。PLR对1年死亡率的预测作用微弱（OR 1.01；95% CI 1.00 - 1.02）。然而，在对NLR和PLR进行调整后，只有STS-PROM评分显著预测总生存率（风险比1.07；95% CI 1.02 - 1.12；p = 0.03）。
NLR与TAVI后的30天死亡率相关。PLR不是TAVI后死亡率的临床显著预测因子。只有STS-PROM评分仍然是总生存率的显著预测因子。
