Open AccessTumor necrosis factor alpha—an underestimated risk predictor in patients undergoing transcatheter aortic valve replacement (TAVR)?
Author(s) -
Mirna Moritz,
Holnthoner Mario,
Topf Albert,
Jirak Peter,
Fejzic Dzeneta,
Paar Vera,
Kellermair Jörg,
Blessberger Hermann,
Reiter Christian,
Kammler Jürgen,
Motloch Lukas J.,
Jung Christian,
Kretzschmar Daniel,
Franz Marcus,
Alushi Brunilda,
Lauten Alexander,
Hoppe Uta C.,
Steinwender Clemens,
Lichtenauer Michael
Publication year - 2021
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.23977
Subject(s) - medicine , proportional hazards model , valve replacement , hazard ratio , confounding , cardiology , univariate analysis , risk factor , biomarker , tumor necrosis factor alpha , multivariate analysis , gastroenterology , confidence interval , stenosis , biochemistry , chemistry
Background Systemic inflammation has been identified as a major cardiovascular risk factor in patients undergoing transcatheter aortic valve replacement (TAVR), yet currently, it is not adequately portrayed in scores for pre‐interventional risk assessment. The aim of this study was to investigate the predictive ability of TNF‐α in TAVR. Methods A total of 431 patients undergoing transfemoral TAVR were enrolled in this study. Blood samples were drawn prior to intervention, 24 h post‐intervention, 4, 5, and 7 days post‐intervention, and 1, 3, and 6 months post‐TAVR. Results In a univariate Cox proportional hazard analysis, plasma concentrations of TNF‐α after 24 h and after 5 days were associated with mortality after 12 months (after 24 h: HR 1.002 (1.000–1.004), p = 0.028; after 5d: HR 1.003 (1.001–1.005), p = 0.013). This association remained significant even after correction for confounders in a multivariate Cox regression analysis. Additionally, cut‐offs were calculated. Patients above the cut‐off for TNF‐α after 5d had a significantly worse 12‐month mortality than patients below the cut‐off (18.8% vs. 2.8%, p = 0.046). Conclusion Plasma levels of TNF‐α after 24 h and 5 days were independently associated with 12‐month mortality in patients undergoing TAVR. Thus, TNF‐α could represent a novel biomarker for enhanced risk stratification in these patients.