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. 2025 Jul 22;14(15):5196.
doi: 10.3390/jcm14155196.

Preoperative Outcome Predictors in Aortic Valve Replacement: A Single-Center Retrospective Study

Ilenia Foffa  1   2 , Augusto Esposito  3 , Ludovica Simonini  1 , Roberta Lombardi  2 , Maria Serena Parri  2 , Angelo Monteleone  4 , Pier Andrea Farneti  5 , Cecilia Vecoli  1   2
Affiliations

Preoperative Outcome Predictors in Aortic Valve Replacement: A Single-Center Retrospective Study

Ilenia Foffa et al. J Clin Med. .

Abstract

Background: Several blood biomarkers have shown a major role in predicting major adverse complications (MACs) in patients who have undergone cardiac surgery. Here, we aimed to investigate the possible role of the blood urea nitrogen (BUN) to serum albumin ratio (BAR) and the inflammatory prognostic index (IPI) in predicting major adverse complication after surgical aorta valve replacement (SAVR). Methods: The clinical, echocardiographic, and clinical-chemistry laboratory data of 195 patients who underwent SAVR were evaluated. The post-surgical MACs (death, surgical re-exploration, myocardial infarction and cerebral ischemia) during the hospitalization were recorded. Univariate and multivariate logistic regression analyses were studied by comparing the basic clinical features, echocardiographic parameters, and patients' hematological indices between patients with or without MACs. Results: The mean age was 66.1 years, and 62.5% were males. Logistic regression analysis showed that the left atrium volume (LAV), BAR, and IPI as either continuous or categorical variables were independently associated with MACs. Moreover, we found a combined effect of higher LAV with a higher value of BAR or IPI. Combined higher levels of LAV and BAR increased the risk of developing MACs by 9.8 (CI 95% = 2.8-34.3, p = 0.0003), while higher values of LAV and IPI increased the risk of developing MACs by 4.5. Conclusions: Higher levels of BAR and IPI, alone or in combination with higher LAVs, showed an independent predictive value of MACs after SAVR. These findings strongly support the importance of evaluating easily available biomarkers of the pre-operative status of patients in order to predict adverse outcomes.

Keywords: aortic valve replacement; inflammatory prognostic index (IPI); outcome predictors; serum albumin ratio (BAR).

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Forest plot of the odds ratio and its 95% confidence interval for comparison of categorical predictor variables (LAVI, BAR, IPI) for the odds of having major adverse complications (MACs). Abbreviations as in Table 3.
Figure 2
Figure 2
A diagram of the study flow: biomarkers and risk stratification for major adverse complications (MACs).
See this image and copyright information in PMC

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References

    1. Pittams A.P., Iddawela S., Zaidi S., Tyson N., Harky A. Scoring Systems for Risk Stratification in Patients Undergoing Cardiac Surgery. J. Cardiothorac. Vasc. Anesth. 2022;36:1148–1156. doi: 10.1053/j.jvca.2021.03.005. - DOI - PubMed
    1. Vahanian A., Beyersdorf F., Praz F., Milojevic M., Baldus S., Bauersachs J., Capodanno D., Conradi L., De Bonis M., De Paulis R., et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease: Developed by the task force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) Eur. Heart J. 2022;43:561–632. doi: 10.1093/eurheartj/ehab395. - DOI - PubMed
    1. Otto C.M., Nishimura R.A., Bonow R.O., Carabello B.A., Erwin J.P., 3rd, Gentile F., Jneid H., Krieger E.V., Mack M., McLeod C., et al. 2020 ACC/AHA guideline for the Management of Patients with Valvular Heart Disease: A report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines. Circulation. 2021;143:e35–e71. doi: 10.1161/CIR.0000000000000932. - DOI - PubMed
    1. Crawford T.C., Magruder J.T., Grimm J.C., Suarez-Pierre A., Sciortino C.M., Mandal K., Zehr K.J., Conte J.V., Higgins R.S., Cameron D.E., et al. Complications after cardiac operations: All are not created equal. Ann. Thorac. Surg. 2017;103:32–40. doi: 10.1016/j.athoracsur.2016.10.022. - DOI - PubMed
    1. Ball L., Costantino F., Pelosi P. Postoperative complications of patients undergoing cardiac surgery. Curr. Opin. Crit. Care. 2016;22:386–392. doi: 10.1097/MCC.0000000000000319. - DOI - PubMed

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