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Implications of Elevated Fibrosis-4 Index in Patients Receiving Trans-Catheter Aortic Valve Replacement

Background: The prognostic implication of the fibrosis-4 index, which represents the degree of hepatic injury, on patients receiving trans-catheter aortic valve replacement (TAVR) remains unknown. Methods: Patients who underwent TAVR to treat severe aortic stenosis at our institute between 2015 and...

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Autores principales: Imamura, Teruhiko, Narang, Nikhil, Onoda, Hiroshi, Tanaka, Shuhei, Ushijima, Ryuichi, Sobajima, Mitsuo, Fukuda, Nobuyuki, Ueno, Hiroshi, Kinugawa, Koichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8705603/
https://www.ncbi.nlm.nih.gov/pubmed/34945074
http://dx.doi.org/10.3390/jcm10245778
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author Imamura, Teruhiko
Narang, Nikhil
Onoda, Hiroshi
Tanaka, Shuhei
Ushijima, Ryuichi
Sobajima, Mitsuo
Fukuda, Nobuyuki
Ueno, Hiroshi
Kinugawa, Koichiro
author_facet Imamura, Teruhiko
Narang, Nikhil
Onoda, Hiroshi
Tanaka, Shuhei
Ushijima, Ryuichi
Sobajima, Mitsuo
Fukuda, Nobuyuki
Ueno, Hiroshi
Kinugawa, Koichiro
author_sort Imamura, Teruhiko
collection PubMed
description Background: The prognostic implication of the fibrosis-4 index, which represents the degree of hepatic injury, on patients receiving trans-catheter aortic valve replacement (TAVR) remains unknown. Methods: Patients who underwent TAVR to treat severe aortic stenosis at our institute between 2015 and 2020 were included in this retrospective study and followed for 2 years from the index discharge. The impact of the fibrosis-4 index, which was calculated using age, hepatic enzymes, and platelet count, on 2-year heart failure readmissions was investigated. Results: A total of 272 patients (median age 85 (82, 88) years old, 76 (28%) men) were included. The median baseline fibrosis-4 index was 2.8 (2.2, 3.7). A high fibrosis-4 index (>3.79) was associated with higher cumulative incidence of the primary endpoint (18% versus 4%, p < 0.001) and higher event rates (0.1041 versus 0.0222 events/year, p < 0.001), with an adjusted hazard ratio of 1.27 (95% confidence interval 1.04–1.54, p = 0.019). Conclusion: an elevated fibrosis-4 index at baseline, indicating the existence of persistent hepatic congestion, was associated with incidences of heart failure following TAVR. Calculating the fibrosis-4 index before TAVR is highly encouraged for risk stratification and shared decision making.
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spelling pubmed-87056032021-12-25 Implications of Elevated Fibrosis-4 Index in Patients Receiving Trans-Catheter Aortic Valve Replacement Imamura, Teruhiko Narang, Nikhil Onoda, Hiroshi Tanaka, Shuhei Ushijima, Ryuichi Sobajima, Mitsuo Fukuda, Nobuyuki Ueno, Hiroshi Kinugawa, Koichiro J Clin Med Article Background: The prognostic implication of the fibrosis-4 index, which represents the degree of hepatic injury, on patients receiving trans-catheter aortic valve replacement (TAVR) remains unknown. Methods: Patients who underwent TAVR to treat severe aortic stenosis at our institute between 2015 and 2020 were included in this retrospective study and followed for 2 years from the index discharge. The impact of the fibrosis-4 index, which was calculated using age, hepatic enzymes, and platelet count, on 2-year heart failure readmissions was investigated. Results: A total of 272 patients (median age 85 (82, 88) years old, 76 (28%) men) were included. The median baseline fibrosis-4 index was 2.8 (2.2, 3.7). A high fibrosis-4 index (>3.79) was associated with higher cumulative incidence of the primary endpoint (18% versus 4%, p < 0.001) and higher event rates (0.1041 versus 0.0222 events/year, p < 0.001), with an adjusted hazard ratio of 1.27 (95% confidence interval 1.04–1.54, p = 0.019). Conclusion: an elevated fibrosis-4 index at baseline, indicating the existence of persistent hepatic congestion, was associated with incidences of heart failure following TAVR. Calculating the fibrosis-4 index before TAVR is highly encouraged for risk stratification and shared decision making. MDPI 2021-12-10 /pmc/articles/PMC8705603/ /pubmed/34945074 http://dx.doi.org/10.3390/jcm10245778 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Imamura, Teruhiko
Narang, Nikhil
Onoda, Hiroshi
Tanaka, Shuhei
Ushijima, Ryuichi
Sobajima, Mitsuo
Fukuda, Nobuyuki
Ueno, Hiroshi
Kinugawa, Koichiro
Implications of Elevated Fibrosis-4 Index in Patients Receiving Trans-Catheter Aortic Valve Replacement
title Implications of Elevated Fibrosis-4 Index in Patients Receiving Trans-Catheter Aortic Valve Replacement
title_full Implications of Elevated Fibrosis-4 Index in Patients Receiving Trans-Catheter Aortic Valve Replacement
title_fullStr Implications of Elevated Fibrosis-4 Index in Patients Receiving Trans-Catheter Aortic Valve Replacement
title_full_unstemmed Implications of Elevated Fibrosis-4 Index in Patients Receiving Trans-Catheter Aortic Valve Replacement
title_short Implications of Elevated Fibrosis-4 Index in Patients Receiving Trans-Catheter Aortic Valve Replacement
title_sort implications of elevated fibrosis-4 index in patients receiving trans-catheter aortic valve replacement
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8705603/
https://www.ncbi.nlm.nih.gov/pubmed/34945074
http://dx.doi.org/10.3390/jcm10245778
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