C-Reactive Protein to Albumin Ratio as A Novel Inflammatory-Based Marker for 30-Day Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement

Objective: We aimed to investigate whether C-reactive protein to albumin ratio (CAR) predicts the early and late mortality in patients undergoing transcatheter aortic valve replacement (TAVR). Methods: This study was retrospectively designed and includes 170 TAVR patients with a mean age of 78.4 +/- 7.1 years. Patients were divided into 2 groups as those who died and those who survived, taking into account the follow-up period. Complete blood count, serum CRP and serum albumin were obtained on admission. The CAR value of all patients was calculated and the relationship of CAR with early (<= 30 days) and late mortality (>30 days) was evaluated. Results: The median follow-up period was 19 [7-31] months (maximum 66 months). Early mortality was observed in 20 (11.8%) patients, whereas late mortality was observed in 39 (22.9%) patients, most of them male (61.1%, P=0.04). Non-survivors had greater CAR value, higher baseline serum CRP level and lower baseline albumin level than survivors (P<0.01, for all parameters). According to multivariate analysis models, CAR (HR: 1.020, P<0.01) and TVAR score (HR: 1.294, P<0.01) were found to be independent predictors of early mortality while CRP and albumin were not. The area under the curve (AUC) for CAR was 0.73 with a P <0.01. A CAR >15.6 predicted the early mortality with 80% sensitivity and 57% specificity. Conclusion: The novel inflammatory marker CAR can be used as a reliable marker in predicting 30-day mortality in patients undergoing TAVR.

Automated summary

This study found that the C-reactive protein to albumin ratio (CAR) can predict early mortality in patients undergoing transcatheter aortic valve replacement (TAVR), with high sensitivity and specificity. This novel inflammatory marker has the potential to become an important indicator for assessing mortality risk in TAVR patients.