Analysis between groups
Of 179 patients, 48 had CAs before TAVR and 131 had not (Table 1). As
expected, PPI rate after TAVR were higher in patients with previous CAs
(33.3% vs 13%, p 0.002). Median time to implant was similar in both
groups: 2 days (1-6.9) in patients with versus 2.5 days (1-7.1) in
patients without CAs, p 0.894. In this latter group, 1 patient underwent
PPI 21 days after the procedure.
Baseline demographic and clinical characteristics and CT variables were
similar in the two groups. The only significant differences were a
higher rate of chronic renal failure and a lower rate of advanced NYHA
class (III-IV) in patients with previous CAs.
To analyze a possible role of NLR in predicting PPI, patients were
stratified by PPI need (Table 2).
In patients with CAs, CRP levels, neutrophil count and NLR at any moment
(fig. 1) did not differ between patients receiving and those not
receiving PPI.
In patients without CAs, NLR values on the day of TAVR and at upon
admission were significantly higher in patients receiving PPI (fig. 2).
In addition, non-coronary cusp calcification score and eccentricity
index, as assessed by CT, were significantly higher in patients
receiving PPI. On the contrary, implantation depth (mean, non-coronary
cusp and left coronary cusp implantation depth) did not differ between
patients receiving and those not receiving PPI.
Multivariable logistic regression confirmed that NLR at TAVR day was an
independent predictor of PPI (OR 1,294; 95% IC 1,028-1,630; p 0,028).
ROC curve analysis showed that a NLR ratio of >7.25 at TAVR
day was associated with a higher prevalence of PPI in patients without
CAs (AUC 0.716; sensibility 65% and specificity 73%, p 0.003) (fig.
3).