Uzman Osman, Bastopcu Murat, Saygı Mehmet, Kalenderoğlu Koray, Demir Koray, Keskin Kıvanç, Terzi Sait
Department of Cardiology, Health Sciences University, Dr Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.
Department of Cardiology, Hisar Intercontinental Hospital, Istanbul, Turkey.
Biomark Med. 2025 Jun;19(12):481-489. doi: 10.1080/17520363.2025.2517524. Epub 2025 Jun 12.
This study assesses the influence of early hyperlactatemia after the transcatheter aortic valve implantation (TAVI) procedure on subsequent outcomes.
Adult patients undergoing elective percutaneous TAVI between 2012 and 2022 in a single tertiary cardiac center were retrospectively included. Peak post-procedure lactate level within 24-h was recorded for 284 patients included in the study. The primary outcome measured was 30-day mortality.
19 patients (6.6%) experienced 30-day mortality. Patients with mortality were characterized by advanced age ( = 0.022) and higher lactate levels after the procedure (5.4 ± 5.4 mmol/L vs 1.3 ± 0.6 mmol/L, < 0.001). Post-procedure hyperlactatemia was an independent predictor of mortality (OR 3.95, 95% CI 1.35-11.60, = 0.012). ROC analysis revealed 1.54 mmol/L as a cutoff for mortality with 85.7% specificity and 68.4% sensitivity.
The initial 24-hour lactate levels seem to play a valuable role in predicting the likelihood of surviving during the hospital stay after the implantation procedure. Further investigation is required to ascertain the optimal strategies for managing early post-procedure hyperlactatemia in the TAVI population.
本研究评估经导管主动脉瓣植入术（TAVI）后早期高乳酸血症对后续结局的影响。
回顾性纳入2012年至2022年在单一三级心脏中心接受择期经皮TAVI的成年患者。记录了纳入研究的284例患者术后24小时内的乳酸峰值水平。测量的主要结局是30天死亡率。
19例患者（6.6%）发生30天死亡。死亡患者的特征为年龄较大（P = 0.022）且术后乳酸水平较高（5.4±5.4 mmol/L对1.3±0.6 mmol/L，P < 0.001）。术后高乳酸血症是死亡的独立预测因素（OR 3.95，95%CI 1.35 - 11.60，P = 0.012）。ROC分析显示，以1.54 mmol/L作为死亡的临界值，特异性为85.7%，敏感性为68.4%。
最初24小时的乳酸水平似乎在预测植入术后住院期间的存活可能性方面发挥着重要作用。需要进一步研究以确定TAVI人群术后早期高乳酸血症的最佳管理策略。
