2012
Prognostic Utility of Biomarkers in Predicting of One- Year Outcomes in Patients with Aortic Stenosis Treated with Transcatheter or Surgical Aortic Valve Implantation
PAŘENICA, Jiří; Petr NĚMEC; Josef TOMANDL; Jiří ONDRÁŠEK; Monika PÁVKOVÁ GOLDBERGOVÁ et al.Základní údaje
Originální název
Prognostic Utility of Biomarkers in Predicting of One- Year Outcomes in Patients with Aortic Stenosis Treated with Transcatheter or Surgical Aortic Valve Implantation
Autoři
PAŘENICA, Jiří; Petr NĚMEC; Josef TOMANDL ORCID; Jiří ONDRÁŠEK; Monika PÁVKOVÁ GOLDBERGOVÁ; Martin TŘETINA; Jiří JARKOVSKÝ ORCID; Simona LITTNEROVÁ; Martin POLOCZEK; Petr POKORNÝ; Jindřich ŠPINAR; Zdeňka ČERMÁKOVÁ; Roman MIKLÍK; Petr MALÍK; Ondřej PEŠ; Jolana LIPKOVÁ ORCID; Marie TOMANDLOVÁ a Petr KALA
Vydání
PloS ONE, 2012, 1932-6203
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30201 Cardiac and Cardiovascular systems
Stát vydavatele
Česká republika
Utajení
není předmětem státního či obchodního tajemství
Impakt faktor
Impact factor: 3.730
Označené pro přenos do RIV
Ano
Kód RIV
RIV/00216224:14110/12:00062521
Organizační jednotka
Lékařská fakulta
UT WoS
Klíčová slova anglicky
Aortic Stenosis; Transcatheter; Aortic Valve Implantation; Outcome
Změněno: 22. 4. 2013 18:46, Ing. Mgr. Věra Pospíšilíková
Anotace
V originále
Objectives: The aim of the work was to find biomarkers identifying patients at high risk of adverse clinical outcomes after TAVI and SAVR in addition to currently used predictive model (EuroSCORE). Methods: The multi-biomarker sub-study included 42 consecutive high-risk patients (average age 82.0 years; logistic EuroSCORE 21.0%) allocated to TAVI transfemoral and transapical using the Edwards-Sapien valve (n = 29), or SAVR with the Edwards Perimount bioprosthesis (n = 13). Standardized endpoints were prospectively followed during the 12-month follow-up. Results: The clinical outcomes after both TAVI and SAVR were comparable. Malondialdehyde served as the best predictor of a combined endpoint at 1 year with AUC (ROC analysis) = 0.872 for TAVI group, resp. 0.765 (p,0.05) for both TAVI and SAVR groups. Increased levels of MDA, matrix metalloproteinase 2, tissue inhibitor of metalloproteinase (TIMP1), ferritin-reducing ability of plasma, homocysteine, cysteine and 8-hydroxy-2-deoxyguanosine were all predictors of the occurrence of combined safety endpoints at 30 days (AUC 0.750–0.948; p,0.05 for all). The addition of MDA to a currently used clinical model (EuroSCORE) significantly improved prediction of a combined safety endpoint at 30 days and a combined endpoint (0–365 days) by the net reclassification improvement (NRI) and the integrated discrimination improvement (IDI) (p,0.05). Cystatin C, glutathione, cysteinylglycine, asymmetric dimethylarginine, nitrite/nitrate and MMP9 did not prove to be significant. Total of 14.3% died during 1-year follow-up. Conclusion: We identified malondialdehyde, a marker of oxidative stress, as the most promising predictor of adverse outcomes during the 30-day and 1-year follow-up in high-risk patients with symptomatic, severe aortic stenosis treated with TAVI. The development of a clinical ‘‘TAVIscore’’ would be highly appreciated. Such dedicated scoring system would enable further testing of adjunctive value of various biomarkers.
Návaznosti
| MUNI/A/0831/2011, interní kód MU |
|