Additive prognostic value of carbohydrate antigen‐125 over frailty in patients undergoing transcatheter aortic valve replacement
Background To evaluate the additive prognostic value of myocardial, inflammatory, and renal biomarkers according to frailty status in patients undergoing transcatheter aortic valve replacement (TAVR) for aortic stenosis (AS). Methods A total of 111 subjects who underwent TAVR at Hospital Italiano de...
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| Veröffentlicht in: | Catheterization and cardiovascular interventions 2021-02, Vol.97 (2), p.E263-E273 |
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| creator | Romeo, Francisco José Seropian, Ignacio Miguel Chiabrando, Juan Guido Raleigh, Juan Valle Smietniansky, Maximiliano Cal, Mariela Falconi, Mariano Kotowicz, Vadim Agatiello, Carla Romina Berrocal, Daniel Horacio |
| description | Background
To evaluate the additive prognostic value of myocardial, inflammatory, and renal biomarkers according to frailty status in patients undergoing transcatheter aortic valve replacement (TAVR) for aortic stenosis (AS).
Methods
A total of 111 subjects who underwent TAVR at Hospital Italiano de Buenos Aires, Argentina between January 2016 and December 2018 were retrospectively reviewed. Plasma levels of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP), high sensitivity troponin T (hs‐cTnT), C‐reactive protein (CRP), cystatin‐c (Cys‐C) and carbohydrate antigen‐125 (CA‐125) were assessed prior to TAVR. Frailty status was assessed according to the fried physical frailty phenotype (FPFP). The primary endpoint was defined as all‐cause death and/or readmission for worsening congestive heart failure (CHF) within the first year after TAVR.
Results
Of the 111 patients included, 48/111 (43%) were considered to be “frail” according to the FPFP. Among biomarkers, we found CA‐125 to be strongly associated with the primary endpoint (p = .006). CA‐125 ≥ 18.2 U/ml was present in 41% and was associated with a higher rate of the primary endpoint (31% vs. 9%; p = .003). After multivariable adjustment, CA‐125 ≥ 18.2 U/ml (hazard ratio [HR] 3.17; p = .024) was the only independent predictor of the primary endpoint. Finally, the inclusion of CA‐125 to frailty significantly improved C‐index (0.68–0.74; p |
| doi_str_mv | 10.1002/ccd.29067 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2418728932</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2489273430</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3537-dff4c4d82b5645f917f2f7255d1954baddfe7625e73cf57b2e1aac8be945b0843</originalsourceid><addsrcrecordid>eNp10b1uFDEUBeARApEfKHgBZImGFJvYd-zxuIyWBJAi0YBEN_LY1xtHs_ZiezbaLuIJeEaeJIZdKJCo7OLzub46TfOK0XNGKVwYY89B0U4-aY6ZAFhI6L4-PdyZ4t1Rc5LzHaVUdaCeN0ctCCUp9MfN90trffFbJJsUVyHm4g3Z6mlGEh0xOo3xdmeTLkh0KH6F4efDDwaCxC0m4pL2U9kRH8hGF4-hZDIHi2kVfViRknTIRpdbLBXrmA7hdVrCzaQNruuTF80zp6eMLw_nafPl-urz8sPi5tP7j8vLm4VpRSsX1jluuO1hFB0XTjHpwEkQwjIl-KitdSg7EChb44QcAZnWph9RcTHSnrenzdt9bt3024y5DGufDU6TDhjnPABnvYRetVDpm3_oXZxTqL-rqlcgW97Sqs72yqSYc0I3bJJf67QbGB1-FTPUYobfxVT7-pA4j2u0f-WfJiq42IN7P-Hu_0nDcvluH_kI_aGatg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2489273430</pqid></control><display><type>article</type><title>Additive prognostic value of carbohydrate antigen‐125 over frailty in patients undergoing transcatheter aortic valve replacement</title><source>Access via Wiley Online Library</source><creator>Romeo, Francisco José ; Seropian, Ignacio Miguel ; Chiabrando, Juan Guido ; Raleigh, Juan Valle ; Smietniansky, Maximiliano ; Cal, Mariela ; Falconi, Mariano ; Kotowicz, Vadim ; Agatiello, Carla Romina ; Berrocal, Daniel Horacio</creator><creatorcontrib>Romeo, Francisco José ; Seropian, Ignacio Miguel ; Chiabrando, Juan Guido ; Raleigh, Juan Valle ; Smietniansky, Maximiliano ; Cal, Mariela ; Falconi, Mariano ; Kotowicz, Vadim ; Agatiello, Carla Romina ; Berrocal, Daniel Horacio</creatorcontrib><description>Background
To evaluate the additive prognostic value of myocardial, inflammatory, and renal biomarkers according to frailty status in patients undergoing transcatheter aortic valve replacement (TAVR) for aortic stenosis (AS).
Methods
A total of 111 subjects who underwent TAVR at Hospital Italiano de Buenos Aires, Argentina between January 2016 and December 2018 were retrospectively reviewed. Plasma levels of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP), high sensitivity troponin T (hs‐cTnT), C‐reactive protein (CRP), cystatin‐c (Cys‐C) and carbohydrate antigen‐125 (CA‐125) were assessed prior to TAVR. Frailty status was assessed according to the fried physical frailty phenotype (FPFP). The primary endpoint was defined as all‐cause death and/or readmission for worsening congestive heart failure (CHF) within the first year after TAVR.
Results
Of the 111 patients included, 48/111 (43%) were considered to be “frail” according to the FPFP. Among biomarkers, we found CA‐125 to be strongly associated with the primary endpoint (p = .006). CA‐125 ≥ 18.2 U/ml was present in 41% and was associated with a higher rate of the primary endpoint (31% vs. 9%; p = .003). After multivariable adjustment, CA‐125 ≥ 18.2 U/ml (hazard ratio [HR] 3.17; p = .024) was the only independent predictor of the primary endpoint. Finally, the inclusion of CA‐125 to frailty significantly improved C‐index (0.68–0.74; p < .05), and provided a Net Reclassification Improvement (NRI) of 0.34 (95% CI 0.19–0.49, p = .031), largely through reductions in risk estimates among pre‐frail and frail patients.
Conclusions
CA‐125, a tumor biomarker, outperformed frailty for predicting the primary endpoint within the first year after TAVR.</description><identifier>ISSN: 1522-1946</identifier><identifier>EISSN: 1522-726X</identifier><identifier>DOI: 10.1002/ccd.29067</identifier><identifier>PMID: 32597028</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Antigens ; Aortic stenosis ; Aortic valve ; aortic valve stenosis ; Biomarkers ; Calcium-binding protein ; carbohydrate antigen‐125 ; Congestive heart failure ; Frailty ; Inflammation ; Phenotypes ; Plasma levels ; Reclassification ; Stenosis ; transcatheter aortic valve replacement ; Troponin ; Troponin T</subject><ispartof>Catheterization and cardiovascular interventions, 2021-02, Vol.97 (2), p.E263-E273</ispartof><rights>2020 Wiley Periodicals LLC.</rights><rights>2021 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3537-dff4c4d82b5645f917f2f7255d1954baddfe7625e73cf57b2e1aac8be945b0843</citedby><cites>FETCH-LOGICAL-c3537-dff4c4d82b5645f917f2f7255d1954baddfe7625e73cf57b2e1aac8be945b0843</cites><orcidid>0000-0003-1261-5785 ; 0000-0002-6823-4001 ; 0000-0002-2128-8280</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fccd.29067$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fccd.29067$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32597028$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Romeo, Francisco José</creatorcontrib><creatorcontrib>Seropian, Ignacio Miguel</creatorcontrib><creatorcontrib>Chiabrando, Juan Guido</creatorcontrib><creatorcontrib>Raleigh, Juan Valle</creatorcontrib><creatorcontrib>Smietniansky, Maximiliano</creatorcontrib><creatorcontrib>Cal, Mariela</creatorcontrib><creatorcontrib>Falconi, Mariano</creatorcontrib><creatorcontrib>Kotowicz, Vadim</creatorcontrib><creatorcontrib>Agatiello, Carla Romina</creatorcontrib><creatorcontrib>Berrocal, Daniel Horacio</creatorcontrib><title>Additive prognostic value of carbohydrate antigen‐125 over frailty in patients undergoing transcatheter aortic valve replacement</title><title>Catheterization and cardiovascular interventions</title><addtitle>Catheter Cardiovasc Interv</addtitle><description>Background
To evaluate the additive prognostic value of myocardial, inflammatory, and renal biomarkers according to frailty status in patients undergoing transcatheter aortic valve replacement (TAVR) for aortic stenosis (AS).
Methods
A total of 111 subjects who underwent TAVR at Hospital Italiano de Buenos Aires, Argentina between January 2016 and December 2018 were retrospectively reviewed. Plasma levels of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP), high sensitivity troponin T (hs‐cTnT), C‐reactive protein (CRP), cystatin‐c (Cys‐C) and carbohydrate antigen‐125 (CA‐125) were assessed prior to TAVR. Frailty status was assessed according to the fried physical frailty phenotype (FPFP). The primary endpoint was defined as all‐cause death and/or readmission for worsening congestive heart failure (CHF) within the first year after TAVR.
Results
Of the 111 patients included, 48/111 (43%) were considered to be “frail” according to the FPFP. Among biomarkers, we found CA‐125 to be strongly associated with the primary endpoint (p = .006). CA‐125 ≥ 18.2 U/ml was present in 41% and was associated with a higher rate of the primary endpoint (31% vs. 9%; p = .003). After multivariable adjustment, CA‐125 ≥ 18.2 U/ml (hazard ratio [HR] 3.17; p = .024) was the only independent predictor of the primary endpoint. Finally, the inclusion of CA‐125 to frailty significantly improved C‐index (0.68–0.74; p < .05), and provided a Net Reclassification Improvement (NRI) of 0.34 (95% CI 0.19–0.49, p = .031), largely through reductions in risk estimates among pre‐frail and frail patients.
Conclusions
CA‐125, a tumor biomarker, outperformed frailty for predicting the primary endpoint within the first year after TAVR.</description><subject>Antigens</subject><subject>Aortic stenosis</subject><subject>Aortic valve</subject><subject>aortic valve stenosis</subject><subject>Biomarkers</subject><subject>Calcium-binding protein</subject><subject>carbohydrate antigen‐125</subject><subject>Congestive heart failure</subject><subject>Frailty</subject><subject>Inflammation</subject><subject>Phenotypes</subject><subject>Plasma levels</subject><subject>Reclassification</subject><subject>Stenosis</subject><subject>transcatheter aortic valve replacement</subject><subject>Troponin</subject><subject>Troponin T</subject><issn>1522-1946</issn><issn>1522-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp10b1uFDEUBeARApEfKHgBZImGFJvYd-zxuIyWBJAi0YBEN_LY1xtHs_ZiezbaLuIJeEaeJIZdKJCo7OLzub46TfOK0XNGKVwYY89B0U4-aY6ZAFhI6L4-PdyZ4t1Rc5LzHaVUdaCeN0ctCCUp9MfN90trffFbJJsUVyHm4g3Z6mlGEh0xOo3xdmeTLkh0KH6F4efDDwaCxC0m4pL2U9kRH8hGF4-hZDIHi2kVfViRknTIRpdbLBXrmA7hdVrCzaQNruuTF80zp6eMLw_nafPl-urz8sPi5tP7j8vLm4VpRSsX1jluuO1hFB0XTjHpwEkQwjIl-KitdSg7EChb44QcAZnWph9RcTHSnrenzdt9bt3024y5DGufDU6TDhjnPABnvYRetVDpm3_oXZxTqL-rqlcgW97Sqs72yqSYc0I3bJJf67QbGB1-FTPUYobfxVT7-pA4j2u0f-WfJiq42IN7P-Hu_0nDcvluH_kI_aGatg</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Romeo, Francisco José</creator><creator>Seropian, Ignacio Miguel</creator><creator>Chiabrando, Juan Guido</creator><creator>Raleigh, Juan Valle</creator><creator>Smietniansky, Maximiliano</creator><creator>Cal, Mariela</creator><creator>Falconi, Mariano</creator><creator>Kotowicz, Vadim</creator><creator>Agatiello, Carla Romina</creator><creator>Berrocal, Daniel Horacio</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1261-5785</orcidid><orcidid>https://orcid.org/0000-0002-6823-4001</orcidid><orcidid>https://orcid.org/0000-0002-2128-8280</orcidid></search><sort><creationdate>20210201</creationdate><title>Additive prognostic value of carbohydrate antigen‐125 over frailty in patients undergoing transcatheter aortic valve replacement</title><author>Romeo, Francisco José ; Seropian, Ignacio Miguel ; Chiabrando, Juan Guido ; Raleigh, Juan Valle ; Smietniansky, Maximiliano ; Cal, Mariela ; Falconi, Mariano ; Kotowicz, Vadim ; Agatiello, Carla Romina ; Berrocal, Daniel Horacio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3537-dff4c4d82b5645f917f2f7255d1954baddfe7625e73cf57b2e1aac8be945b0843</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Antigens</topic><topic>Aortic stenosis</topic><topic>Aortic valve</topic><topic>aortic valve stenosis</topic><topic>Biomarkers</topic><topic>Calcium-binding protein</topic><topic>carbohydrate antigen‐125</topic><topic>Congestive heart failure</topic><topic>Frailty</topic><topic>Inflammation</topic><topic>Phenotypes</topic><topic>Plasma levels</topic><topic>Reclassification</topic><topic>Stenosis</topic><topic>transcatheter aortic valve replacement</topic><topic>Troponin</topic><topic>Troponin T</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Romeo, Francisco José</creatorcontrib><creatorcontrib>Seropian, Ignacio Miguel</creatorcontrib><creatorcontrib>Chiabrando, Juan Guido</creatorcontrib><creatorcontrib>Raleigh, Juan Valle</creatorcontrib><creatorcontrib>Smietniansky, Maximiliano</creatorcontrib><creatorcontrib>Cal, Mariela</creatorcontrib><creatorcontrib>Falconi, Mariano</creatorcontrib><creatorcontrib>Kotowicz, Vadim</creatorcontrib><creatorcontrib>Agatiello, Carla Romina</creatorcontrib><creatorcontrib>Berrocal, Daniel Horacio</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Catheterization and cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Romeo, Francisco José</au><au>Seropian, Ignacio Miguel</au><au>Chiabrando, Juan Guido</au><au>Raleigh, Juan Valle</au><au>Smietniansky, Maximiliano</au><au>Cal, Mariela</au><au>Falconi, Mariano</au><au>Kotowicz, Vadim</au><au>Agatiello, Carla Romina</au><au>Berrocal, Daniel Horacio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Additive prognostic value of carbohydrate antigen‐125 over frailty in patients undergoing transcatheter aortic valve replacement</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Catheter Cardiovasc Interv</addtitle><date>2021-02-01</date><risdate>2021</risdate><volume>97</volume><issue>2</issue><spage>E263</spage><epage>E273</epage><pages>E263-E273</pages><issn>1522-1946</issn><eissn>1522-726X</eissn><abstract>Background
To evaluate the additive prognostic value of myocardial, inflammatory, and renal biomarkers according to frailty status in patients undergoing transcatheter aortic valve replacement (TAVR) for aortic stenosis (AS).
Methods
A total of 111 subjects who underwent TAVR at Hospital Italiano de Buenos Aires, Argentina between January 2016 and December 2018 were retrospectively reviewed. Plasma levels of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP), high sensitivity troponin T (hs‐cTnT), C‐reactive protein (CRP), cystatin‐c (Cys‐C) and carbohydrate antigen‐125 (CA‐125) were assessed prior to TAVR. Frailty status was assessed according to the fried physical frailty phenotype (FPFP). The primary endpoint was defined as all‐cause death and/or readmission for worsening congestive heart failure (CHF) within the first year after TAVR.
Results
Of the 111 patients included, 48/111 (43%) were considered to be “frail” according to the FPFP. Among biomarkers, we found CA‐125 to be strongly associated with the primary endpoint (p = .006). CA‐125 ≥ 18.2 U/ml was present in 41% and was associated with a higher rate of the primary endpoint (31% vs. 9%; p = .003). After multivariable adjustment, CA‐125 ≥ 18.2 U/ml (hazard ratio [HR] 3.17; p = .024) was the only independent predictor of the primary endpoint. Finally, the inclusion of CA‐125 to frailty significantly improved C‐index (0.68–0.74; p < .05), and provided a Net Reclassification Improvement (NRI) of 0.34 (95% CI 0.19–0.49, p = .031), largely through reductions in risk estimates among pre‐frail and frail patients.
Conclusions
CA‐125, a tumor biomarker, outperformed frailty for predicting the primary endpoint within the first year after TAVR.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>32597028</pmid><doi>10.1002/ccd.29067</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-1261-5785</orcidid><orcidid>https://orcid.org/0000-0002-6823-4001</orcidid><orcidid>https://orcid.org/0000-0002-2128-8280</orcidid></addata></record> |
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| subjects | Antigens Aortic stenosis Aortic valve aortic valve stenosis Biomarkers Calcium-binding protein carbohydrate antigen‐125 Congestive heart failure Frailty Inflammation Phenotypes Plasma levels Reclassification Stenosis transcatheter aortic valve replacement Troponin Troponin T |
| title | Additive prognostic value of carbohydrate antigen‐125 over frailty in patients undergoing transcatheter aortic valve replacement |
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