Turk Kardiyol Dern Ars. Ahead of Print: TKDA-97709 | DOI: 10.5543/tkda.2020.97709
Effect of prognostic nutritional index on short-term survival after transcatheter aortic valve implantation
, Emre Yılmaz
, İsmail Gürbak
, Fatih Uzun
, Mehmet Ertürk
Istanbul Health Sciences University, Mehmet Akif Ersoy Cardiovascular and Thoracic Surgery Training and Research Hospital, Istanbul
INTRODUCTION Transcatheter aortic valve implantation (TAVI) is a good alternative to surgical aortic valve replacement (SAVR) in patients who are at intermediate, high-risk or unsuitable for SAVR in severe aortic stenosis cases. TAVI is mostly performed elderly patients and although conventional risk scores include a lot of comorbidities, they do not contain functional decline specific to elderly patients. Prognostic nutritional index (PNI), which is a simple and effective parameter for both nutritional and inflammatory status, reflects functional decline in elder people. The aim of the study is to determine the effect of PNI on short-term survival after TAVI.
METHODS We evaluated the PNI value of 302 patients who underwent TAVI. The study population was divided into two groups according to a cutoff value of PNI: PNI > 43.37 (n = 213; 70%) and PNI < 43.37 (n = 89; 30%).
RESULTS Patients with lower PNI had significantly higher mortality rates at 30-day period than patients with higher PNI levels (3.3% vs. 31.5%; p < 0.001). Major vascular complications, and cardiac tamponade were found to be significantly higher in the lower PNI group. The cut-off value of PNI for a 30-day survival was 43.37 with 94.3% specificity and 73.4% sensitivity and negative predictive value of PNI was 96.7%. PNI was found to be an independent risk factor for 30-day mortality after TAVI.
CONCLUSION The higher levels of PNI were associated with short-term survival and decreased post-TAVI complications.
prognostic nutritional index, aortic stenosis, transcatheter aortic valve implantation
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Corresponding Author: Cafer Panç, Türkiye