Background. Previous research reported adverse clinical outcomes in association with systemic inflammation (SI) after transcatheter aortic valve replacement (TAVR). However, data characterizing the impact of SI, as reflected by postprocedural routine inflammatory parameters (pRIP), on clinical outcome of patients undergoing TAVR are sparse. Objectives. In light of this, the present work aimed to analyze incidence and clinical significance of pRIP after transapical (TA) and transfemoral (TF)-TAVR. Methods and Results. Data of 81 high-risk consecutive patients undergoing TAVR in our center from 2017 to 2018 were analyzed in a retrospective manner. 40 out of 81 patients (49, 4%) were treated via TF access (group A) and 41 patients via TA access (group B). Incidence, cause, and amplitude of pRIP were analyzed in relation to pre- and peri-interventional data. Assessment of outcomes was conducted according to the valve academic research consortium (VARC-2). Postprocedural C-reactive protein (pCRP) and leucocytes (pL) were significantly increased in patients undergoing TA-TAVR (group B) vs. TF-TAVR (group A; 12.1 ± 9.7 vs. 22.1 ± 7.9 mg/dl,  < 0.001 and 12.8 ± 4.0 vs. 14.2 ± 3.8/nl,  = 0.002); however, there was no significant difference regarding incidence of postprocedural fever (pF) ≥38.0°C (12.5% vs. 22%,  = 0.37). Furthermore, we observed a vast (though insignificant) trend towards a longer fever duration in group B vs. group A (9.9 ± 14.9 vs. 3.2 ± 5.9 hours,  = 0.06). Further analysis identified pCRP >30 mg/dl (hazard ratio (HR) 3.15, confidence interval (CI) 1.22–8.14,  = 0.018) and European System for Cardiac Operative Risk Evaluation (logistic EuroSCORE I (ES)) >20% (HR 2.95, CI 1.17–7.47,  = 0.02) as predictors of mortality; in this context, we also discovered a marginally significant trend for pL > 14/nl (HR 2.44, CI 0.97–6.14,  = 0.05). Multivariate analysis by use of the fisher`s exact test revealed a significant association between pCRP >30 mg/dl and ES >20% ( < 0.001). Conclusion. pRIP are significantly increased in patients undergoing TA-TAVR. pCRP >30 mg/dl, ES>20%, and pL > 14/nl are hallmark of adverse prognosis and require further investigation.

中文翻译：

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常规炎症参数对经导管主动脉瓣置换术后结果的发生率和影响

背景。先前的研究报告了经导管主动脉瓣置换术 (TAVR) 后与全身炎症 (SI) 相关的不良临床结果。然而，如术后常规炎症参数 (pRIP) 所反映的 SI 对接受 TAVR 患者临床结果的影响的数据很少。目标。有鉴于此，本工作旨在分析经心尖 (TA) 和经股 (TF)-TAVR 后 pRIP 的发生率和临床意义。方法和结果. 回顾性分析我中心2017-2018年81例连续接受TAVR的高危患者资料。81 名患者中有 40 名（49 名，4%）通过 TF 通路治疗（A 组），41 名患者通过 TA 通路治疗（B 组）。pRIP 的发生率、原因和幅度与介入前和介入期数据相关。根据瓣膜学术研究联盟 (VARC-2) 对结果进行评估。接受 TA-TAVR（B 组）与 TF-TAVR（A 组；12.1 ± 9.7 vs. 22.1 ± 7.9 mg/dl， < 0.001 和12.8 ± 4.0 与 14.2 ± 3.8/nl， = 0.002)；然而，术后发热 (pF) ≥38.0°C 的发生率没有显着差异（12.5% 对 22%， = 0.37)。 此外，我们观察到 B 组与 A 组相比发热持续时间更长（9.9 ± 14.9 对 3.2 ± 5.9 小时， = 0.06）的巨大（尽管微不足道）趋势。进一步分析确定 pCRP >30 mg/dl（风险比 (HR) 3.15，置信区间 (CI) 1.22–8.14， = 0.018）和欧洲心脏手术风险评估系统（物流 EuroSCORE I (ES)）>20%（HR 2.95, CI 1.17–7.47,  = 0.02) 作为死亡率的预测因子；在这种情况下，我们还发现 pL > 14/nl 的趋势略微显着（HR 2.44，CI 0.97–6.14， = 0.05）。通过使用 Fisher 精确检验进行的多变量分析显示 pCRP >30 mg/dl 和 ES >20% (  <0.001) 之间存在显着关联。结论. pRIP 在接受 TA-TAVR 的患者中显着增加。pCRP >30 mg/dl、ES>20% 和 pL >14/nl 是不良预后的标志，需要进一步调查。