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NEUTROPHIL TO LYMPHOCYTE RATIO PREDICTS PERMANENT PACEMAKER IMPLANTATION IN TAVR PATIENTS
  • +7
  • Antonio Totaro,
  • Gianluca Testa,
  • Antonio Calafiore,
  • Vincenzo Ienco,
  • Vincenzo Sacra,
  • Andrea Busti,
  • Antonio Pierro,
  • Simona Sperlongano,
  • Paolo Golino,
  • Cosimo Sacra
Antonio Totaro
Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Corresponding Author:[email protected]

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Gianluca Testa
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Antonio Calafiore
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Vincenzo Ienco
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Vincenzo Sacra
Universita degli Studi della Campania Luigi Vanvitelli
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Andrea Busti
Universita degli Studi del Molise Dipartimento di Medicina e Scienze della Salute Vincenzo Tiberio
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Antonio Pierro
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Simona Sperlongano
Universita degli Studi della Campania Luigi Vanvitelli
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Paolo Golino
Universita degli Studi della Campania Luigi Vanvitelli
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Cosimo Sacra
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
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Abstract

Introduction. In this prospective multicenter analysis, we aimed to investigate the predictive role of neutrophil/lymphocyte ratio (NLR) in permanent pacemaker implantation (PPI) in patients undergoing transcatheter aortic valve replacement (TAVR). Material and methods. 179 consecutive patients without previous PPI underwent TAVR from February 2017 to September 2021. Patients were further divided based on presence (n=48) and absence of conduction abnormalities (CAs) at hospital admission (n=131). Results . In patients with previous CAs, NLR values did not differ significantly between patients requiring PPI (n=16, 33%) and those not requiring it. In contrast, in patients with no CAs at hospital admission, NLR values measured at admission and on TAVR day were significantly higher in patients requiring PPI (n=17, 13%) (4.07±3.22 vs 3.01±1.47, p=0.025, and 10.81±7.81 vs 5.84±3.78, p=0.000, respectively). Multivariable analysis showed that NLR at TAVR day was an independent predictor of PPI in patients without CAs (OR 1.294; 95% CI 1.028-1.630; p=0.028), but not in those with previous CAs. ROC curve analysis showed that the cut point was a NLR value of >7.25. Time to PPI was delayed till 21 days in patients without CAs. Conclusions. In this prospective study, higher NLR values on the day of TAVR day were associated with an increased PPI rate in patients undergoing TAVR with no previous CAs. It is advisable, being inflammation part of the process, to prolong the time of observation for all patients without CAs till at least 21 days not to miss any new CA necessitating PPI.
03 Oct 2022Submitted to Journal of Cardiac Surgery
03 Oct 2022Submission Checks Completed
03 Oct 2022Assigned to Editor
21 Oct 2022Reviewer(s) Assigned
27 Oct 2022Review(s) Completed, Editorial Evaluation Pending
29 Oct 2022Editorial Decision: Accept
15 Nov 2022Published in Journal of Cardiac Surgery. 10.1111/jocs.17212