Hioki H, et al. - Researchers determined the influence of high serum C-reactive protein (CRP) and high-sensitive CRP (hs-CRP) level on all-cause death after transcatheter aortic valve implantation (TAVI). High CRP on admission was shown to be significantly related to an increased risk of all-cause death following TAVI, specifically within the first 3-months post-TAVI. For identifying high-risk patients who undergo TAVI, risk stratification using CRP may be a simple and useful strategy.

Methods

• Assessment of 1016 TAVI patients with CRP and 538 TAVI patients with high-sensitive CRP (hs-CRP) level was done on admission in the OCEAN (Optimized transCathEter vAlvular interveNtion)-TAVI registry.
• Based on the median of CRP and hs-CRP on admission, 2 groups (high/low) were identified.

Results

• Post- TAVI, all-cause death was 9.4% in patients with CRP and 11.9% in patients with hs-CRP, as observed during 2-year follow-up.
• In both CRP and hs-CRP, median value of serum CRP was 0.10mg/dL.
• Significantly higher incidence of all-cause death was observed among patients with high CRP (> 0.10mg/dL) vs those with low CRP (11.5% vs 7.6%, log-rank P=0.015).
• By multivariate Cox regression analysis with a time-varying covariate, high CRP independently predicted all-cause death within the first 3-months (HR, 2.78; 95%CI, 1.30–5.95) vs 3-months onward to 2-years (HR, 0.80; 95%CI, 0.47–1.36) (P for interaction = 0.008).
• In the stratification using hs-CRP on admission, these results were not observed.