Premium
Prognostic impact of baseline C‐reactive protein levels on mortality after transcatheter aortic valve implantation
Author(s) -
Takagi Hisato,
Kuno Toshiki,
Hari Yosuke,
Nakashima Kouki,
Yokoyama Yujiro,
Ueyama Hiroki,
Ando Tomo
Publication year - 2020
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14499
Subject(s) - medicine , hazard ratio , confidence interval , c reactive protein , odds ratio , meta analysis , cardiology , inflammation
Objectives To determine whether baseline C‐reactive protein (CRP) levels can predict mortality after transcatheter aortic valve implantation (TAVI), we performed a meta‐analysis of currently available studies. Methods All studies investigating the prognostic impact of baseline (preprocedural) CRP levels on all‐cause mortality after TAVI were identified by means of searching PubMed and Google Scholar through May 2019. For each study, (preferentially, adjusted rather than unadjusted) odds/hazard ratios (ORs/HRs) with corresponding 95% confidence intervals of mortality per standard‐deviation (SD) (or unit) increase in CRP levels or those for high vs low CRP levels. Results Our search identified 14 eligible studies including a total of 3449 patients undergoing TAVI and reporting early (in‐hospital to 3‐month) and midterm (1‐year to 3‐year) all‐cause mortality after TAVI. Pooled analyses demonstrated associations of high‐baseline CRP levels with a marginal, but statistically nonsignificant increase in early mortality (pooled OR/HR per SD increase in CRP levels, 2.72; P = .09 and pooled OR/HR for high vs low CRP levels, 3.32; P = .07) and a statistically significant increase in midterm mortality after TAVI (pooled OR/HR per SD increase in CRP levels, 1.45; P < .0001 and pooled OR/HR for high vs low CRP levels, 1.78; P < .00001). Excluding HRs for high‐sensitivity CRP, combining ORs/HRs of 1‐year mortality, pooling HRs of ≥2‐year mortality, and combining adjusted HRs did not alter the primary results. Conclusion High‐baseline CRP levels may predict increased midterm, but not early, mortality after TAVI.