Key result
Higher C-reactive protein to albumin ratio was an independent predictor of long-term mortality (OR 1.221; 95% CI 1.125-1.325; P<0.001) in patients with severe aortic stenosis undergoing surgical AVR.
Why the study?
To evaluate the prognostic value of the C-reactive protein to albumin ratio in patients with severe aortic valve stenosis undergoing surgical aortic valve replacement.
Does the C-reactive protein to albumin ratio predict long-term mortality in patients with severe degenerative aortic stenosis undergoing surgical aortic valve replacement?
Cohort (n=476)
Does the C-reactive protein to albumin ratio predict long-term mortality in patients with severe degenerative aortic stenosis undergoing surgical aortic valve replacement?
Odds Ratio: 1.221 (95% CI 1.125–1.325)
p-value: p=<0.001
The C-reactive protein to albumin ratio is an independent predictor of long-term mortality, rehospitalization, paravalvular leakage, and reoperation in patients undergoing surgical aortic valve replacement for severe aortic stenosis.
May aid preoperative risk stratification in surgical AVR; hypothesis-generating and requires prospective validation before clinical use.
OBJECTIVE: To evaluate the prognostic value of C-reactive protein to albumin ratio (CAR) in patients with severe aortic valve stenosis undergoing surgical aortic valve replacement (AVR). METHODS: Four hundred seventy-six patients with severe degenerative aortic stenosis who underwent successful isolated surgical AVR were enrolled. Hospitalization due to heart failure, surgical aortic reoperation, paravalvular leakage rates, and long-term mortality were evaluated in the whole study group. The participants were divided into two groups, as 443 patients without mortality (group 1) and 33 patients with mortality (group 2) during the follow-up time. RESULTS: CAR was lower in patients without mortality than in those with mortality during the follow-up time (0.84 [0.03-23.43] vs. 2.50 [0.22-26.55], respectively, P<0.001). Age (odds ratio [OR]: 1.062, confidence interval [CI]: 1.012-1.114, P=0.014), CAR (OR: 1.221, CI: 1.125-1.325, P<0.001), ejection fraction (OR: 0.956, CI: 0.916-0.998, P=0.042), and valve type (OR: 2.634, CI: 1.045-6.638, P=0.040) were also found to be independent predictors of long-term mortality. Additionally, rehospitalization (0.86 [0.03-26.55] vs. 1.6 [0.17-24.05], P=0.006), aortic reoperation (0.87 [0.03-26.55] vs. 1.6 [0.20-23.43], P=0.016), and moderate to severe aortic paravalvular leakage (0.86 [0.03-26.55] vs. 1.86 [0.21-19.50], P=0.023) ratios were associated with higher CAR. CONCLUSION: It was firstly described that CAR was strongly related with increased mortality rates in patients with isolated severe aortic stenosis after surgical AVR. Additionally, rehospitalization, risk of paravalvular leakage, and aortic reoperation rates were higher in patients with increased CAR than in those without it.
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Kahraman et al. (2019) conducted a cohort in severe degenerative aortic stenosis (n=476). C-reactive protein to albumin ratio (CAR) vs. Lower CAR was evaluated on long-term mortality (OR 1.221, 95% CI 1.125-1.325, p=<0.001). Higher C-reactive protein to albumin ratio was an independent predictor of long-term mortality (OR 1.221; 95% CI 1.125-1.325; P<0.001) in patients with severe aortic stenosis undergoing surgical AVR.
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