Preprocedural neutrophil-to-lymphocyte ratio: A novel predictor of permanent pacemaker implantation in self-expandable vs balloon-expandable valve cohorts following transcatheter aortic valve implantation

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart Rhythm O2 Pub Date : 2025-06-01 DOI:10.1016/j.hroo.2025.03.003

Haitham Abu Khadija MD , Mohammad Alnees MD , Omar Ayyad MD , Gera Gandelman MD , Gal Sella MD , Nizar Abu Hamdeh MD , Amir Haim MD , Yazan Hamdan MD , Alena Kirzhner MD , Abdalaziz Darwish MD , Duha Najajra MD , Tal Schiller MD , Alex Blatt MD , Jacob George MD

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Abstract

Background

Transcatheter aortic valve implantation (TAVI) is the preferred treatment for severe aortic stenosis. This study examines the neutrophil-lymphocyte ratio (NLR) as a predictor of permanent pacemaker implantation (PPI) outcomes, comparing self-expandable valves (SEVs) and balloon-expandable valves (BEVs).

Objective

This study aims to evaluate the effectiveness of the NLR in predicting PPI outcomes in patients undergoing TAVI with SEVs and BEVs.

Methods

This retrospective cohort study at Kaplan Medical Center analyzed 305 patients with severe symptomatic aortic stenosis referred for TAVI from January 2010 to December 2019. Data on baseline characteristics, laboratory results, and clinical outcomes were collected, including NLR and PPI rates. Two logistic regression models were developed to identify predictors of TAVI-PPI outcomes for SEV and BEV cohorts.

Results

In the SEV cohort, 59 of 199 patients (29.6%) required PPI, compared with 15 of 106 patients (14.2%) in the BEV cohort. The receiver operating characteristic (ROC) curve for SEV showed an area under the curve (AUC) of 0.70, indicating predictive ability of the NLR for TAVI-PPI outcomes. The BEV cohort had a lower AUC of 0.40 (P = .03). In the SEV model, significant predictors included NLR (odds ratio [OR]: 1.146, P =.040) and total protein levels (OR: 0.012, P = .029). In the BEV model, the QTc interval was significant (OR: 1.023, P = .018).

Conclusion

The NLR significantly predicts permanent pacemaker implantation after TAVI, especially for SEVs, but less for BEVs.

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术前中性粒细胞与淋巴细胞比率：经导管主动脉瓣植入术后自膨胀与球囊膨胀瓣膜队列永久性起搏器植入术的新预测指标

背景：经导管主动脉瓣植入术（TAVI）是严重主动脉瓣狭窄的首选治疗方法。本研究将中性粒细胞-淋巴细胞比率（NLR）作为永久性起搏器植入（PPI）结果的预测指标，并比较了自膨胀瓣膜（sev）和球囊膨胀瓣膜（bev）。目的本研究旨在评估NLR对伴有sev和bev的TAVI患者PPI预后的预测效果。方法卡普兰医学中心的这项回顾性队列研究分析了2010年1月至2019年12月因TAVI转诊的305例严重症状性主动脉瓣狭窄患者。收集基线特征、实验室结果和临床结果的数据，包括NLR和PPI率。开发了两个逻辑回归模型来确定SEV和BEV队列TAVI-PPI结果的预测因子。结果在SEV队列中，199例患者中有59例（29.6%）需要PPI，而在BEV队列中，106例患者中有15例（14.2%）需要PPI。SEV的受试者工作特征（ROC）曲线显示曲线下面积（AUC）为0.70，表明NLR对TAVI-PPI结果具有预测能力。BEV组的AUC较低，为0.40 （P = 0.03）。在SEV模型中，显著预测因子包括NLR（比值比[OR]: 1.146, P = 0.040）和总蛋白水平（OR: 0.012, P = 0.029）。在BEV模型中，QTc区间具有显著性（OR: 1.023, P = 0.018）。结论NLR对TAVI术后永久性起搏器植入术有显著预测作用，尤其是对sev，而对bev影响较小。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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