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Use of the reported Edmonton frail scale in the assessment of patients for transcatheter aortic valve replacement： a possible selection tool in very high-risk patients？

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Journal of Geriatric Cardiology 2018年第6期15卷 463-466页

作者： Louis Koizia Sarosh Khan Angela Frame Ghada W Mikhail sayan sen Neil Ruparelia Geriatric Medicine St Mary's Hospital Praed Street London UK Department of Cardiology Western Sussex Hospitals NHS Foundation Trust West Sussex UK Department of Cardiology lmperial College Healthcare NHS Trust London UK

Transcatheter aortic valve replacement （TAVR） has revolutionised the treatment of patients with aortic stenosis （AS） over the last 15 *** is a well-established procedure for the treatment of patients considered high risk for open surgery. Results from the PARTNER （Placement of AoRTic traNscathetER） trial showed that inoperable patients randomly assigned to TAVR, had a 20% reduction in all-cause mortality, as well as hospitalisation, at one year compared to best medical management.

关键词： Edmonton frail scale Frailty Transcatheter aortic valve replacement

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Impact of clinical and procedural factors upon C reactive protein dynamics following transcatheter aortic valve implantation

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World Journal of Cardiology 2016年第7期8卷 425-431页

作者： sayan sen Iqbal S Malik Antonio Colombo Ghada W Mikhail Department of Cardiology Hammersmith HospitalImperial NHS Healthcare Trust San Raffaele Scientific Institute

AIM: To determine the effect of procedural and clinical factors upon C reactive protein(CRP) dynamics following transcatheter aortic valve implantation(TAVI).METHODS: Two hundred and eight consecutive patients that underwent transfemoral TAVI at two hospitals(Imperial, College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom and San Raffaele Scientific Institute, Milan, Italy) were included. Daily venous plasma CRP levels were measured for up to 7 d following the procedure(or up to discharge). Procedural factors and 30-d safety outcomes according tothe Valve Academic Research Consortium 2 definition were collected. RESULTS: Following TAVI, CRP significantly increased reaching a peak on day 3 of 87.6 ± 5.5 mg/d L, P sence of diabetes mellitus was associated with a significantly higher peak CRP level at day 3(78.4 ± 3.2 vs 92.2 ± 4.4, P < 0.001). There was no difference in peak CRP release following balloonexpandable or self-expandable TAVI implantation(94.8 ± 9.1 vs 81.9 ± 6.9, P = 0.34) or if post-dilatation was required(86.9 ± 6.3 vs 96.6 ± 5.3, P = 0.42), however, when pre-TAVI balloon aortic valvuloplasty was performed this resulted in a significant increase in the peak CRP(110.1 ± 8.9 vs 51.6 ± 3.7, P < 0.001). The development of a major vascular complication did result in a significantly increased maximal CRP release(153.7 ± 11.9 vs 83.3 ± 7.4, P = 0.02) and there was a trend toward a higher peak CRP following major/lifethreatening bleeding(113.2 ± 9.3 vs 82.7 ± 7.5, P = 0.12) although this did not reach statistical significance. CRP was not found to be a predictor of 30-d mortality on univariate analysis. CONCLUSION: Careful attention should be paid to baseline clinical characteristics and procedural factors when interpreting CRP following TAVI to determine their future management.

关键词： Aortic stenosis Transcatheter aortic valve implantation C reactive protein Inflammation

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