Prognostic Value of Procalcitonin/Albumin Ratio in Predicting Outcomes After Transcatheter Aortic Valve Implantation.

Background: Transcatheter aortic valve implantation (TAVI) has emerged as preferred treatment for severe aortic stenosis in high-risk patients. Inflammatory and nutritional biomarkers have been increasingly investigated for their prognostic value. This study aimed to evaluate the utility of the procalcitonin/albumin ratio (PAR) in predicting 1-year mortality after TAVI. Methods: A retrospective cohort study was conducted on patients who underwent TAVI between June 2020 and January 2024. Pre-procedural serum procalcitonin and albumin levels were measured, and the PAR was calculated. Thirty-day and 1-year mortality and hospitalization for heart failure were defined as primary outcomes. Results: A total of 210 patients were included in the study. PAR was significantly higher in non-survivors compared to survivors (p < 0.0001). Receiver operating characteristic analysis demonstrated that the PAR had a moderate-to-good discriminatory ability for predicting 1-year mortality (area under the curve = 0.784 [95% confidence interval: 0.709-0.858]). In multivariate analysis, PAR was identified as an independent predictor of 30-day and 1-year mortality and hospitalization for heart failure. Conclusions: Our findings suggest that the PAR, as a combined marker of inflammation and nutritional status, may serve as a useful prognostic indicator in patients undergoing TAVI. The association between a higher PAR and increased mortality risk highlights the potential role of systemic inflammation and malnutrition in post-TAVI outcomes. The pre-procedural PAR appears to be a promising biomarker for predicting 1-year mortality after TAVI. Further prospective studies with larger cohorts are needed to validate these findings and explore potential clinical applications.