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@article{1079912,
author = {Pařenica, Jiří and Němec, Petr and Tomandl, Josef and Ondrášek, Jiří and Pávková Goldbergová, Monika and Třetina, Martin and Jarkovský, Jiří and Littnerová, Simona and Poloczek, Martin and Pokorný, Petr and Špinar, Jindřich and Čermáková, Zdeňka and Miklík, Roman and Malík, Petr and Peš, Ondřej and Lipková, Jolana and Tomandlová, Marie and Kala, Petr},
article_number = {12},
doi = {http://dx.doi.org/10.1371/journal.pone.0048851},
keywords = {Aortic Stenosis; Transcatheter; Aortic Valve Implantation; Outcome},
language = {eng},
issn = {1932-6203},
journal = {PloS ONE},
title = {Prognostic Utility of Biomarkers in Predicting of One- Year Outcomes in Patients with Aortic Stenosis Treated with Transcatheter or Surgical Aortic Valve Implantation},
volume = {7},
year = {2012}
}
TY - JOUR
ID - 1079912
AU - Pařenica, Jiří - Němec, Petr - Tomandl, Josef - Ondrášek, Jiří - Pávková Goldbergová, Monika - Třetina, Martin - Jarkovský, Jiří - Littnerová, Simona - Poloczek, Martin - Pokorný, Petr - Špinar, Jindřich - Čermáková, Zdeňka - Miklík, Roman - Malík, Petr - Peš, Ondřej - Lipková, Jolana - Tomandlová, Marie - Kala, Petr
PY - 2012
TI - Prognostic Utility of Biomarkers in Predicting of One- Year Outcomes in Patients with Aortic Stenosis Treated with Transcatheter or Surgical Aortic Valve Implantation
JF - PloS ONE
VL - 7
IS - 12
SP - e48851
EP - e48851
SN - 19326203
KW - Aortic Stenosis
KW - Transcatheter
KW - Aortic Valve Implantation
KW - Outcome
N2 - 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.
ER -
PAŘENICA, Jiří, Petr NĚMEC, Josef TOMANDL, Jiří ONDRÁŠEK, Monika PÁVKOVÁ GOLDBERGOVÁ, Martin TŘETINA, Jiří JARKOVSKÝ, Simona LITTNEROVÁ, Martin POLOCZEK, Petr POKORNÝ, Jindřich ŠPINAR, Zdeňka ČERMÁKOVÁ, Roman MIKLÍK, Petr MALÍK, Ondřej PEŠ, Jolana LIPKOVÁ, Marie TOMANDLOVÁ and Petr KALA. Prognostic Utility of Biomarkers in Predicting of One- Year Outcomes in Patients with Aortic Stenosis Treated with Transcatheter or Surgical Aortic Valve Implantation. \textit{PloS ONE}. 2012, vol.~7, No~12, p.~e48851, 11 pp. ISSN~1932-6203. Available from: https://dx.doi.org/10.1371/journal.pone.0048851.
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