Cargando…
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...
Autores principales: | , , , , , , , , |
---|---|
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 |
_version_ | 1784621987428040704 |
---|---|
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. |
format | Online Article Text |
id | pubmed-8705603 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT imamurateruhiko implicationsofelevatedfibrosis4indexinpatientsreceivingtranscatheteraorticvalvereplacement AT narangnikhil implicationsofelevatedfibrosis4indexinpatientsreceivingtranscatheteraorticvalvereplacement AT onodahiroshi implicationsofelevatedfibrosis4indexinpatientsreceivingtranscatheteraorticvalvereplacement AT tanakashuhei implicationsofelevatedfibrosis4indexinpatientsreceivingtranscatheteraorticvalvereplacement AT ushijimaryuichi implicationsofelevatedfibrosis4indexinpatientsreceivingtranscatheteraorticvalvereplacement AT sobajimamitsuo implicationsofelevatedfibrosis4indexinpatientsreceivingtranscatheteraorticvalvereplacement AT fukudanobuyuki implicationsofelevatedfibrosis4indexinpatientsreceivingtranscatheteraorticvalvereplacement AT uenohiroshi implicationsofelevatedfibrosis4indexinpatientsreceivingtranscatheteraorticvalvereplacement AT kinugawakoichiro implicationsofelevatedfibrosis4indexinpatientsreceivingtranscatheteraorticvalvereplacement |