Prognostic Value of Hypoalbuminemia After Transcatheter Aortic Valve Implantation (from the Japanese Multicenter OCEAN-TAVI Registry)

Masanori Yamamoto, Tetsuro Shimura, Seiji Kano, Ai Kagase, Atsuko Kodama, Mitsuru Sago, Tatsuya Tsunaki, Yutaka Koyama, Norio Tada, Futoshi Yamanaka, Toru Naganuma, Motoharu Araki, Shinichi Shirai, Yusuke Watanabe, Kentaro Hayashida

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Abstract

Hypoalbuminemia, a frailty criterion, belongs to a group of co-morbidities not captured as a traditional risk factor. We assessed its prognostic value in patients who underwent transcatheter aortic valve implantation (TAVI). The study included 1,215 consecutive patients from the Optimized Catheter Valvular Intervention -TAVI Japanese multicenter registry. Hypoalbuminemia was defined as serum albumin level <3.5 g/dl. Baseline characteristics, procedural outcomes, and all-cause, cardiovascular and noncardiovascular mortality rates after TAVI were compared between patients with albumin level <3.5 g/dl (hypo[h]-ALB group, n = 284) and those with albumin level >3.5 g/dl (nonhypo[nh]-ALB group, n = 931). Several baseline characteristics differed significantly between both groups, including age (85.1 ± 5.1 vs 84.2 ± 4.9 years, p = 0.012), ejection fraction (58.5 ± 14.3% vs 62.9 ± 12.4%, p <0.001), baseline kidney function, or liver disease. The 30-day mortality rate in all patients showed significant differences between the 2 groups (3.9% vs 1.3%, p = 0.005). During a mean follow-up of 330 days, cumulative all-cause, cardiovascular, and noncardiovascular mortality rates were significantly higher in the hALB group than in the nhALB group (log-rank test, p <0.001, p = 0.0021, and p <0.001, respectively). The groups were also analyzed using a propensity matching model for adjusting the baseline differences. The analysis revealed that the poorer prognosis of the hALB group in terms of cumulative all-cause and noncardiovascular mortality was retained (p = 0.038, and p = 0.0068, respectively); however, differences in cardiovascular mortality rates in the 2 groups were attenuated (p = 0.93). In conclusion, hypoalbuminemia was associated with poor prognosis, highlighted by the increase in noncardiovascular mortality. Baseline albumin level could be a useful marker for risk stratification before TAVI.

Original languageEnglish
Pages (from-to)770-777
Number of pages8
JournalAmerican Journal of Cardiology
Volume119
Issue number5
DOIs
Publication statusPublished - 2017 Mar 1

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Yamamoto, M., Shimura, T., Kano, S., Kagase, A., Kodama, A., Sago, M., Tsunaki, T., Koyama, Y., Tada, N., Yamanaka, F., Naganuma, T., Araki, M., Shirai, S., Watanabe, Y., & Hayashida, K. (2017). Prognostic Value of Hypoalbuminemia After Transcatheter Aortic Valve Implantation (from the Japanese Multicenter OCEAN-TAVI Registry). American Journal of Cardiology, 119(5), 770-777. https://doi.org/10.1016/j.amjcard.2016.11.019