Adiponectin serum level is an independent and incremental predictor of all-cause mortality after transcatheter aortic valve replacement

Abstract

Background: Quantifiable biomarkers may be useful for a better risk and frailty assessment of patients referred for transcatheter aortic valve implantation (TAVI). Hypothesis: To determine if adiponectin serum concentration predicts all-cause mortality in patients undergoing TAVI. Methods: 77 consecutive patients, undergoing TAVI, were analyzed. The CT axial slices at the level of the fourth lumbar vertebra were used to measure the psoas muscle area, and its low-density muscle fraction (LDM (%)). To assess the operative risk, the STS (Society of Thoracic Surgeons Predicted Risk of Mortality) score, Log. Euroscore, and Euroscore II were determined. A clinical frailty assessment was performed. ELISA kits were used to measure adiponectin serum levels. We searched for a correlation between serum adiponectin concentration and all-cause mortality after TAVI. Results: The mean age was 80.8 ± 7.4 years. All-cause mortality occurred in 22 patients. The mean follow-up was 1779 days (range: 1572–1825 days). Compared with patients with the lowest adiponectin level, patients in the third tertile had a hazards ratio of all-cause mortality after TAVI of 4.155 (95% CI: 1.364–12.655) (p =.004). In the multivariable model, including STS score, vascular access of TAVI procedure, LDM (%), and adiponectin serum concentration, serum adiponectin level, and LDM(%) were independent predictors of all-cause mortality after TAVI (p =.178,.303,.042, and.017, respectively). Adiponectin level was a predictor of all-cause mortality in females and males (p =.012 and 0.024, respectively). Conclusion: Adiponectin serum level is an independent and incremental predictor of all-cause mortality in patients undergoing TAVI.