Background: Red cell distribution width (RDW) is recently emerging as a prognostic indicator in many cardiovascular diseases. However, less is known about its predictive role in patients undergoing transcatheter aortic valve implantation (TAVI). Methods: We retrospectively included very high-risk patients with severe aortic valve stenosis undergoing TAVI between February 2012 and December 2019. Patients were classified according to RDW tertiles. Our primary endpoint was long-term all-cause mortality. The secondary endpoint was a composite of in-hospital major adverse events as defined by the Valve Academic Research Consortium 2 criteria and/or long-term all-cause mortality. Results: A total of 424 patients [median age 83.5 years, 52.6% females] were analysed. After a median follow-up of 1.55 years, all-cause mortality was 25.5%. At the multivariate-adjusted Cox regression analysis, patients in the highest RDW tertile were associated with a higher risk for all-cause mortality [hazard ratio [HR] 1.73, 95%confidence interval [CI] 1.02-2.95] compared with the lowest tertile. When considering RDW as a continuous variable, we found an 11% increased risk in overall mortality [HR 1.11, 95% CI 1.00-1.24] for each increased point in RDW. The highest RDW tertile was also independently associated with the occurrence of the composite endpoint [odds ratio [OR] 2.10, 95% CI 1.17-3.76] compared with lower tertiles. Conclusions: In our cohort, elevated basal RDW values were independent predictors of increased long-term mortality and higher rate of in-hospital adverse events. The inclusion of a routinely available biomarker as RDW, may help the pre-operative risk assessment in potential TAVI candidates and optimise their management.

Red blood cell distribution width in patients undergoing transcatheter aortic valve implantation: Implications for outcomes / Valenti, A. C.; Vitolo, M.; Manicardi, M.; Arrotti, S.; Magnavacchi, P.; Gabbieri, D.; Tondi, S.; Guiducci, V.; Losi, L.; Vignali, L.; Sgura, F. A.; Boriani, G.. - In: INTERNATIONAL JOURNAL OF CLINICAL PRACTICE. - ISSN 1368-5031. - 75:6(2021), pp. e14153-e14153. [10.1111/ijcp.14153]

Red blood cell distribution width in patients undergoing transcatheter aortic valve implantation: Implications for outcomes

Valenti A. C.;Vitolo M.;Manicardi M.;Arrotti S.;Boriani G.
2021

Abstract

Background: Red cell distribution width (RDW) is recently emerging as a prognostic indicator in many cardiovascular diseases. However, less is known about its predictive role in patients undergoing transcatheter aortic valve implantation (TAVI). Methods: We retrospectively included very high-risk patients with severe aortic valve stenosis undergoing TAVI between February 2012 and December 2019. Patients were classified according to RDW tertiles. Our primary endpoint was long-term all-cause mortality. The secondary endpoint was a composite of in-hospital major adverse events as defined by the Valve Academic Research Consortium 2 criteria and/or long-term all-cause mortality. Results: A total of 424 patients [median age 83.5 years, 52.6% females] were analysed. After a median follow-up of 1.55 years, all-cause mortality was 25.5%. At the multivariate-adjusted Cox regression analysis, patients in the highest RDW tertile were associated with a higher risk for all-cause mortality [hazard ratio [HR] 1.73, 95%confidence interval [CI] 1.02-2.95] compared with the lowest tertile. When considering RDW as a continuous variable, we found an 11% increased risk in overall mortality [HR 1.11, 95% CI 1.00-1.24] for each increased point in RDW. The highest RDW tertile was also independently associated with the occurrence of the composite endpoint [odds ratio [OR] 2.10, 95% CI 1.17-3.76] compared with lower tertiles. Conclusions: In our cohort, elevated basal RDW values were independent predictors of increased long-term mortality and higher rate of in-hospital adverse events. The inclusion of a routinely available biomarker as RDW, may help the pre-operative risk assessment in potential TAVI candidates and optimise their management.
75
6
e14153
e14153
Red blood cell distribution width in patients undergoing transcatheter aortic valve implantation: Implications for outcomes / Valenti, A. C.; Vitolo, M.; Manicardi, M.; Arrotti, S.; Magnavacchi, P.; Gabbieri, D.; Tondi, S.; Guiducci, V.; Losi, L.; Vignali, L.; Sgura, F. A.; Boriani, G.. - In: INTERNATIONAL JOURNAL OF CLINICAL PRACTICE. - ISSN 1368-5031. - 75:6(2021), pp. e14153-e14153. [10.1111/ijcp.14153]
Valenti, A. C.; Vitolo, M.; Manicardi, M.; Arrotti, S.; Magnavacchi, P.; Gabbieri, D.; Tondi, S.; Guiducci, V.; Losi, L.; Vignali, L.; Sgura, F. A.; Boriani, G.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1250369
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