title: Thromboinflammatory response and predictors of outcomes in patients undergoing transcatheter aortic valve replacement.
abstract: Transcatheter aortic valve replacement (TAVR) has been increasingly used to treat patients with symptomatic aortic stenosis. Despite improvements in valve deployment, patients that have undergone TAVR are at high risk for major adverse events following the procedure. Blood cell numbers, platelet function, and biomarkers of systemic inflammation were analyzed in 58 patients undergoing TAVR with the Edward's SAPIEN valve. Following valve deployment, platelet count and agonist-induced platelet activity declined and plasma markers of systemic inflammation (interleukin-6 and S100A8/A9) increased. Baseline platelet activity prior to TAVR correlated with perioperative changes plasma interleukin-6 levels. Moreover, perioperative changes in plasma inflammatory markers predicted the decline in platelet count in the days following the TAVR procedure. Additionally, a significant effect of gender on platelet count following TAVR and was observed. Finally, post-procedural mortality was associated with sustained thrombocytopenia after TAVR. Our findings suggest that TAVR elicits a thromboinflammatory state that may contribute to post-procedural thrombocytopenia. Importantly, our results add to the growing body of literature that suggests the thromboinflammatory changes that occur early after TAVR may predict long-term outcomes.
authors.affiliation: The Gill Heart Institute, University of Kentucky, BBSRB B347, Lexington, KY, 40506, USA.
authors.forename: Travis R
authors.initials: TR
authors.lastname: Sexton
authors.affiliation: The Gill Heart Institute, University of Kentucky, BBSRB B347, Lexington, KY, 40506, USA.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Wallace
authors.affiliation: The Gill Heart Institute, University of Kentucky, BBSRB B347, Lexington, KY, 40506, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Chen
authors.affiliation: The Gill Heart Institute, University of Kentucky, BBSRB B347, Lexington, KY, 40506, USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Charnigo
authors.affiliation: The Gill Heart Institute, University of Kentucky, BBSRB B347, Lexington, KY, 40506, USA.
authors.forename: Hassan K
authors.initials: HK
authors.lastname: Reda
authors.affiliation: The Gill Heart Institute, University of Kentucky, BBSRB B347, Lexington, KY, 40506, USA.
authors.forename: Khaled M
authors.initials: KM
authors.lastname: Ziada
authors.affiliation: The Gill Heart Institute, University of Kentucky, BBSRB B347, Lexington, KY, 40506, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Gurley
authors.affiliation: The Gill Heart Institute, University of Kentucky, BBSRB B347, Lexington, KY, 40506, USA. susansmyth@uky.edu.
authors.forename: Susan S
authors.initials: SS
authors.lastname: Smyth
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001772:Blood Cell Count; D040501:Calgranulin A / Q000097:blood; D040502:Calgranulin B / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010979:Platelet Function Tests; D013927:Thrombosis / Q000097:blood*; D065467:Transcatheter Aortic Valve Replacement
chemical_list: D015415:Biomarkers; D040501:Calgranulin A; D040502:Calgranulin B; C508600:IL6 protein, human; D015850:Interleukin-6
keywords: Inflammation; Platelet; Transcutaneous aortic valve replacement