Inflammatory biomarkers as predictors of prognosis in patients after transcatheter aortic valve implantation

Abstract

Background: The expanding role of transcatheter aortic valve implantation (TAVI) highlights the need to identify factors influencing long-term outcomes. Systemic inflammatory response syndrome (SIRS) is a frequent post-procedural event that may adversely affect prognosis. Measurement of inflammatory biomarkers may improve the understanding of underlying mechanisms and refine patient risk stratification. Methods: This single-center, prospective cohort study, enrolled 62 consecutive patients undergoing TAVI, who were followed for up to 5 years. Blood samples were collected before TAVI, at 24 h and 3–6 months post-procedure. Changes in biomarker levels, predictors of SIRS, and inflammatory predictors of long-term outcomes were analyzed. Results: SIRS developed in 45% of patients. Significant temporal changes were observed in hs-CRP, TNF-α, sST2/IL-33, IL-10, and IL-2 levels, irrespective of baseline or procedural characteristics. The development of SIRS was associated with a higher risk of all-cause mortality or unplanned hospitalization at 5 years (HR 3.07, 95% CI 1.57–6.00; p = 0.001). Baseline hs-CRP (HR 1.21, 95% CI 1.09-1.35; p < 0.001) and IFN-γ (HR 1.22; 95% CI 1.09–1.36; p < 0.001) levels were predictive of adverse outcomes. In multivariable Cox analysis, these associations remained, though findings should be interpreted cautiously given the limited sample size. Conclusions: SIRS is a common post-TAVI phenomenon and may be linked to long-term outcomes. Elevated pre-procedural hs-CRP and IFN-γ levels were associated with higher risk for adverse events, suggesting they may serve as exploratory biomarkers for risk stratification in this population.