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Heart and Vessels

, Volume 34, Issue 12, pp 1993–2001 | Cite as

Predictive value of preprocedural procalcitonin for short- and long-term mortality after transfemoral transcatheter aortic valve implantation

  • Stanislav KeranovEmail author
  • Won-Keun Kim
  • Mani Arsalan
  • Matthias Renker
  • Till Keller
  • Timm Bauer
  • Oliver Dörr
  • Holger M. Nef
  • Luise Gaede
  • Helge Möllmann
  • Thomas Walther
  • Christian W. Hamm
  • Christoph Liebetrau
Original Article
  • 67 Downloads

Abstract

Current risk scores used for patients undergoing transcatheter aortic valve implantation (TAVI) do not reliably predict adverse events after TAVI. Procalcitonin (PCT) is associated with increased atherosclerotic burden and adverse outcomes in patients with cardiovascular disease. The aim of our study is to assess the predictive value of preprocedural serum PCT levels in comparison with established risk scores in TAVI patients. A total of 243 patients undergoing transfemoral TAVI at our institution were included prospectively in the study and 230 of these patients participated in the follow-up 1 year after TAVI. The primary endpoints were mortality at 30 days and 1 year. Multivariable analysis revealed that preprocedural PCT was the only independent predictor of 30-day mortality (HR 2.84; 95% CI 1.59–5.06; p < 0.001) and 1-year mortality (HR 1.90; 95% CI 1.17–3.11; p = 0.01), whereas high-sensitivity C-reactive protein showed no association with procedural outcomes. The results of ROC analysis showed good predictive power of PCT for both outcomes (AUC 0.75; p = 0.0003 for 30-day mortality and AUC 0.71; p < 0.0001 for 1-year mortality). An optimal cut-off value for PCT of 0.06 ng/ml for short- and long-term mortality was determined with the Youden index. A significantly higher mortality rate was observed in the high-PCT group (≥ 0.06 ng/ml) based on Kaplan–Meier analysis (log rank = 12.1; p = 0.001 at 30 days and log rank = 14.2; p = 0.0002 at 1 year). Patients in the high-PCT group also had a considerably worse clinical pro6file. In conclusion, preprocedural PCT is an independent predictor of 30-day and 1-year mortality after TAVI. In particular, a cut-off value of 0.06 ng/ml discriminates patients at higher risk of mortality within 30 days and 1 year of TAVI.

Keywords

Procalcitonin Biomarker Risk factor TAVI 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare to have no conflict of interest.

Supplementary material

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Supplementary file1 (DOCX 12 kb)
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Supplementary file4 (DOCX 12 kb)

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Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Stanislav Keranov
    • 1
    • 4
    Email author
  • Won-Keun Kim
    • 1
    • 2
    • 4
  • Mani Arsalan
    • 3
    • 4
  • Matthias Renker
    • 1
    • 3
  • Till Keller
    • 1
    • 4
  • Timm Bauer
    • 5
  • Oliver Dörr
    • 1
    • 2
    • 4
  • Holger M. Nef
    • 1
    • 2
    • 4
  • Luise Gaede
    • 6
  • Helge Möllmann
    • 6
  • Thomas Walther
    • 3
  • Christian W. Hamm
    • 1
    • 2
    • 4
  • Christoph Liebetrau
    • 1
    • 2
    • 4
  1. 1.Department of Cardiology and AngiologyUniversity of GiessenGiessenGermany
  2. 2.Department of CardiologyKerckhoff Heart and Thorax CenterBad NauheimGermany
  3. 3.Department of Cardiac SurgeryKerckhoff Heart and Thorax CenterBad NauheimGermany
  4. 4.DZHK (German Centre for Cardiovascular Research), Partner Site RheinMainFrankfurt am MainGermany
  5. 5.Department of CardiologySana Klinikum OffenbachOffenbachGermany
  6. 6.Department of Internal MedicineSt. Johannes HospitalDortmundGermany

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