Universität zu Köln

Sudo, Mitsumasa, Shamekhi, Jasmin, Sedaghat, Alexander, Aksoy, Adem, Zietzer, Andreas, Tanaka, Tetsu ORCID: 0000-0003-0780-8689, Wilde, Nihal, Weber, Marcel, Sinning, Jan-Malte, Grube, Eberhard, Veulemans, Verena, Adam, Matti, Kelm, Malte, Baldus, Stephan, Nickenig, Georg, Zimmer, Sebastian, Tiyerili, Vedat and Al-Kassou, Baravan (2022). Predictive value of the Fibrosis-4 index in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement. Clin. Res. Cardiol., 111 (12). S. 1367 - 1377. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1861-0692

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Abstract

Background Liver dysfunction is associated with an increased risk of mortality after cardiac interventions. The Fibrosis-4 (FIB-4 index), a marker of hepatic fibrosis, has been associated with a worse prognosis in heart failure. The prognostic relevance of the index in patients undergoing transcatheter aortic valve replacement (TAVR) is unknown. The aim of this study was to evaluate the clinical implications associated with the FIB-4 index in patients undergoing TAVR. Methods Between May 2012 and June 2019, 941 patients undergoing TAVR were stratified into a low or high FIB-4 index group, based on a cutoff value that was determined according to a receiver operating characteristic curve predicting 1-year all-cause mortality. Results Patients with a high FIB-4 index (n = 480), based on the cutoff value of 1.82, showed higher rates of pulmonary hypertension (43.8% vs. 31.8%, p < 0.01), right-ventricular systolic dysfunction (29.5% vs. 19.2%, p < 0.01) and larger inferior vena cava diameter (1.6 +/- 0.6 cm vs. 1.3 +/- 0.6 cm, p < 0.01) than patients with a low FIB-4 index (n = 461). Furthermore, a high FIB-4 index was associated with a significantly higher cumulative 1-year all-cause mortality (17.5% vs. 10.2%, p < 0.01) and non-cardiovascular mortality (12.1% vs. 2.5%, p < 0.01), compared to a low FIB-4 index. Multivariable analysis revealed that a high FIB-4 index was independently associated with all-cause mortality (HR: 1.75 [95% CI: 1.18-2.59], p < 0.01). Conclusions A high FIB-4 index is associated with right-sided heart overload and an increased risk of mortality in patients undergoing TAVR. The FIB-4 index may be useful as an additional predictor of outcomes in these patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Sudo, Mitsumasa UNSPECIFIED UNSPECIFIED UNSPECIFIED Shamekhi, Jasmin UNSPECIFIED UNSPECIFIED UNSPECIFIED Sedaghat, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Aksoy, Adem UNSPECIFIED UNSPECIFIED UNSPECIFIED Zietzer, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Tanaka, Tetsu UNSPECIFIED orcid.org/0000-0003-0780-8689 UNSPECIFIED Wilde, Nihal UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Marcel UNSPECIFIED UNSPECIFIED UNSPECIFIED Sinning, Jan-Malte UNSPECIFIED UNSPECIFIED UNSPECIFIED Grube, Eberhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Veulemans, Verena UNSPECIFIED UNSPECIFIED UNSPECIFIED Adam, Matti UNSPECIFIED UNSPECIFIED UNSPECIFIED Kelm, Malte UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Nickenig, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Zimmer, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Tiyerili, Vedat UNSPECIFIED UNSPECIFIED UNSPECIFIED Al-Kassou, Baravan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-679980
DOI:	10.1007/s00392-022-02055-6
Journal or Publication Title:	Clin. Res. Cardiol.
Volume:	111
Number:	12
Page Range:	S. 1367 - 1377
Date:	2022
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1861-0692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SIMPLE NONINVASIVE INDEX; VALVULAR HEART-DISEASE; TASK-FORCE; IMPLANTATION; MANAGEMENT; DIAGNOSIS; REGURGITATION; ASSOCIATION; GUIDELINES; MORTALITY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67998