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- Title
Prognostic impact of baseline C-reactive protein levels on mortality after transcatheter aortic valve implantation.
- Authors
Takagi, Hisato; Kuno, Toshiki; Hari, Yosuke; Nakashima, Kouki; Yokoyama, Yujiro; Ueyama, Hiroki; Ando, Tomo; ALICE (All-Literature Investigation of Cardiovascular Evidence) Group
- Abstract
<bold>Objectives: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusion: </bold>High-baseline CRP levels may predict increased midterm, but not early, mortality after TAVI.
- Subjects
GOOGLE Scholar (Web resource); HEART valve prosthesis implantation; C-reactive protein; MORTALITY; PREDICTIVE tests; META-analysis; TIME; SYSTEMATIC reviews; PROSTHETIC heart valves
- Publication
Journal of Cardiac Surgery, 2020, Vol 35, Issue 5, p974
- ISSN
0886-0440
- Publication type
journal article
- DOI
10.1111/jocs.14499